Health Insurance

KEY POINTS

This third report extends trends in claims data in this series into 2022, the first year post-NSA implementation. In 2022, the prevalence of out-of-network bills declined 15 percent for emergency services and 11 percent for non-emergency services furnished at in-network facilities relative to 2021.

In the United States, accessing behavioral health care is a persistent and complex challenge, even among those with insurance coverage. Behavioral health care access challenges stem from a combination of provider shortages, systemic barriers, and logistical hurdles. People frequently encounter difficulties determining the type of provider or level of care that best suits their needs.

To explore whether and how the NSA has affected insurer-provider dynamics, contract negotiations, and payment rates, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) asked RAND to conduct discussions with stakeholders. In this report, RAND summarizes the approach exploring these topics, the themes that emerged from our discussions, and areas for additional inquiry.

During the pandemic period, telehealth utilization increased among both urban and rural enrollees in Medicaid, with urban enrollees sustaining greater gains in telehealth utilization at the end of 2021. This Issue Brief is part of a series of ASPE Issue Briefs examining changes in Medicaid utilization of services delivered via telehealth by enrollee and provider characteristics.

Prescription drug prices are a top concern for policymakers and the public, but little data is available on prescription drug prices or other costs that contribute to premiums for commercial drug coverage.

This second report focuses largely on updating pre-NSA trends in claims data presented in the first report.

National estimates indicate that streamlined renewal options for Medicaid beneficiaries with incomes below 100 percent of the federal poverty level and without an ex parte income data source would provide timely and accurate eligibility determinations.

In order to support state and local outreach efforts, ASPE has developed state, county, and local estimates of the number of U.S. residents without health insurance and their demographic characteristics, using the most recent Census data available from the 2023 American Community Survey (ACS).