Category Archive for "Healthcare"

Home »

SSR Index of Current-Quarter Demand Growth: Initial 3Q12 Estimates

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

Read More

Co-Pay Cards: A Bottle for the Drug Pricing Genie

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.

Read More

Medicaid Eligibility Capped at 100 FPL: The Logical Outcome of the SCOTUS ACA Ruling

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

Read More

Protected: Update on post-SCOTUS Medicaid

There is no excerpt because this is a protected post.

Read More

Medicaid Post-SCOTUS: Nevermind Whether States Choose to Expand; It Appears States Have the Choice to Shrink

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

Read More

ACA Post-SCOTUS – What Matters Now

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

Read More

SSR Index of Current-Quarter Demand Growth; Raising Estimate to 3.3% from 3.1%

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

Read More

The Mechanics of Commercial HMOs’ Gross Profits: Why MLRs Should Remain Stable

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

Read More

Healthcare’s Utilization Trade Against the Backdrop of May Jobs Numbers

Summary and Conclusion: In making our pro-cyclical healthcare call we intended to be playing offense; however in the face of a potential slowdown in US employment and the risk of a more substantial economic deterioration in Europe, the pro-cyclical recommendation

Read More

The Apparent Link Between Employment and Healthcare Demand

Privately insured US persons (and presumably households) consume 2.7x the healthcare of age- and health-status adjusted persons (and households) who are uninsured As employment rises and falls, households shift from one category (un-/under-employed, un-/under-insured) to another (employed / insured), and

Read More
test