April 15, 2021

One of the most underappreciated cornerstones of the Affordable Care Act (ACA) is that premium variation...

March 2, 2021

In California, the DMHC and DOI facilitate a transparent and accessible means to look up rates and rating information for plans in the individual and small group market. However, gathering a market-encompassing view of the...

February 5, 2021

Our firm recently hired its first data scientist to complement the consulting team of health actuaries and clinicians. The Actuarial profession is very small and niche, with many people outside of the insurance and pension industries...

December 18, 2020

Nine months ago, we gathered in our conference room to talk about COVID-19 and what it may look like in the coming months. When you put a bunch of data geeks with healthcare expertise in a room the opinions were diverse...

December 2, 2020

What if I told you that two sentences in a rate filing guidance could potentially add $5 billion of federal subsidies to the individual market and bring substantial premium relief...

November 25, 2020

The Affordable Care Act (ACA) provides states with multiple opportunities to improve their local markets. Most options involve a significant investment, both staff time and financial resources. Earlier this year...

November 23, 2020

While health insurers and health plans have historically assumed most of the risk associated with managing the healthcare dollar, recent trends towards capitation and bundled payments show providers having an increased appetite...

November 19, 2020

Last year I developed a ranking system for analyzing consumer value in ACA markets across all 50 states[1]. It was a fun and enlightening exercise. Please see the link below for last year’s rankings which will include the details of...

October 19, 2020

Many people think Blue Cross and Blue Shield is the name of a health insurance company.  When asked, we often hear people say, “My health insurance is through Blue Cross”.  They get confused when followed-up with...