Health affairs
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Patients treated at in-network facilities can involuntarily receive services from out-of-network providers, which may result in "surprise bills." While several studies report the surprise billing prevalence in emergency department and inpatient settings, none document the prevalence in ambulatory surgery centers (ASCs). The extent to which health plans pay a portion or all of out-of-network providers' bills in these situations is also unexplored. We analyzed 4.2 million ASC-based episodes of care in 2014-17, involving 3.3 million patients enrolled in UnitedHealth Group, Humana, and Aetna commercial plans. ⋯ The average balance per episode increased by 81 percent, from $819 in 2014 to $1,483 in 2017. Anesthesiologists (44 percent), certified registered nurse anesthetists (25 percent), and independent laboratories (10 percent) generated most potential surprise bills. There is a need for federal policy to expand protection from surprise bills to patients enrolled in all commercial insurance plans.
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Involuntary psychiatric treatment for people with serious mental illness should focus on returning to health instead of reducing danger.
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Review
Women's Coverage, Utilization, Affordability, And Health After The ACA: A Review Of The Literature.
Women of working age (ages 19-64) faced specific challenges in obtaining health insurance coverage and health care before the Affordable Care Act. Multiple factors contributed to women's experiencing uninsurance, underinsurance, and increased financial burdens related to obtaining health care. ⋯ Despite major progress after the Affordable Care Act's implementation, barriers to coverage, access, and affordability remain, and serious threats to women's health still exist. Highlighting the law's effects on women's health is critical for informing future policies directed toward the continuing improvement of women's health care and health.
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Enrollment in the Marketplaces of the Affordable Care Act (ACA) has fallen short of original expectations, because the ACA's regulatory changes made coverage costlier for many Americans with incomes above 150 percent of the federal poverty level. There are ways to strengthen and expand the role of the individual market in providing affordable, personalized options to all nonelderly Americans. ⋯ Much as the authors of the Affordable Care Act drew on Massachusetts reforms signed into law by Gov. Mitt Romney (R), market-oriented health reformers should learn from the ACA and Medicare's private insurance programs in order to build a personalized, consumer-driven path toward universal coverage.