Author Archive

This note quantifies a ‘baseline’ rate of real growth in US healthcare demand, which we define as the rate of growth one would expect sans any upcoming secular, cyclical, or reform effects We estimate baseline growth of 4.8% +/- 0.9%

We expect 3.8% y/y health services demand growth during 3Q12, the product of 2.0% growth in unit demand and 1.8% growth in pricing Unit demand growth is decelerating, presumably as the result of weakened jobs growth, whose primary impact on

Drug manufacturers pay rebates to avoid exclusion from a formulary and/or to gain preferred formulary position. At retail, formulary position translates into co-pays; consumers pay higher ‘tier 3’ co-pays for non-preferred brands and lower ‘tier 2’ amounts for preferred brands.

When (if) the Affordable Care Act (ACA) is put into effect, states will be free to disenroll beneficiaries to the federal minimums (in many cases < 30 FPL), expand to (or beyond) the ACA’s original target of 138 FPL, or

SCOTUS ruled that Congress cannot withhold all of a state’s Medicaid funding if the state refuses to participate in the Affordable Care Act’s (ACA) Medicaid expansion Many states’ Medicaid eligibility levels are well above the federal minimums, in large part

The Court’s rule modifying the Medicaid expansion (you can make the additional federal funds conditional on state participation in the expansion, but not all Medicaid funds) appears to be violated by the ACA’s Medicaid maintenance of eligibility (MOE) provisions MOE

Hours worked in healthcare settings have grown more rapidly; this signals strong patient volumes, thus the increase in our estimate of unit demand from 1.4% to 1.6%. Our estimate of nominal pricing is unchanged at 1.7% We estimate only a

Estimates and share prices for the commercial HMOs imply rising medical loss ratios (MLRs); stable MLRs are more likely, thus the sub-sector appears under-valued   Since 1961, 5 of the 6 MLR peaks and 6 of the 7 MLR troughs