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Krutika Amin

@krutika.bsky.social
1.2K followers 152 following 108 posts

CCIIO/CMS/HHS. Health economics PhD. #healthpolicy #healthecon

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Krutika Amin @krutika.bsky.social · 16/04/2024
i thought i had 4 things to say, but only have 3, ROFL. forgive me for mis-numbering 😅
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Krutika Amin @krutika.bsky.social · 16/04/2024
3/3 Even if the health care situation is amenable to shopping, payments have moved to value-based models making fee-for-services rates irrelevant. www.healthsystemtracker.org/brief/ongoin...
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Krutika Amin @krutika.bsky.social · 16/04/2024
2/3 Few adults research the price of health care -- Few instances where price transparency is truly possible due to lack of providers in-network or in your area. www.healthsystemtracker.org/brief/few-ad...
healthsystemtracker.org
Few adults are aware of hospital price transparency requirements - Peterson-KFF Health System Tracker
As of January 1 of this year, hospitals are required to post prices of common health services on their websites via consumer-friendly tools for patient use. Prior to implementation of this rule, hospi...
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Krutika Amin @krutika.bsky.social · 16/04/2024
I did a talk on price transparency! hctransparencysummitportal.com/auditorium Some @PetersonCHealth @KFF work I talked about: 1/4 Price transparency bipartisan legislation passed House last year, so Congressional action on price transparency is possible: www.healthsystemtracker.org/brief/policy...
hctransparencysummitportal.com
HC Transparency Summit
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Krutika Amin @krutika.bsky.social · 16/04/2024
22% privately insured people and 30% uninsured people reported rationing insulin because of cost--to save money, among the reasons listed. www.healthsystemtracker.org/brief/out-of...
healthsystemtracker.org
Out-of-pocket spending on insulin among people with private insurance - Peterson-KFF Health System Tracker
The Build Back Better Act, which has passed the House but stalled in the Senate, would cap insulin out-of-pocket costs for people with insurance. Several other recent legislative proposals would also ...
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Krutika Amin @krutika.bsky.social · 16/04/2024
At least 1 in 5 privately insured people taking insulin spend more than $35 per month per insulin product. This share is greater in the small group fully insured market than for Marketplace enrollees (who get income-based deductible and copay subsidies). www.healthsystemtracker.org/brief/out-of...
healthsystemtracker.org
Out-of-pocket spending on insulin among people with private insurance - Peterson-KFF Health System Tracker
The Build Back Better Act, which has passed the House but stalled in the Senate, would cap insulin out-of-pocket costs for people with insurance. Several other recent legislative proposals would also ...
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Krutika Amin @krutika.bsky.social · 16/04/2024
Federal law capping insulin costs to $35 a month is still on Dems health policy agenda. Why? > Reuters: Eli Lilly's nationwide insulin pricing settlement called off www.reuters.com/legal/litiga...
reuters.com
Eli Lilly's nationwide insulin pricing settlement called off
A settlement between Eli Lilly and purchasers of its insulin drugs that would have capped prices and provided $13.5 million to resolve claims that the company inflated the drugs' cost has fallen apart, after an unfavorable ruling from the judge overseeing the case.
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Krutika Amin @krutika.bsky.social · 08/04/2024
Link to PetersonCHealth KFF analysis: www.healthsystemtracker.org/chart-collec...
healthsystemtracker.org
How does cost affect access to healthcare? - Peterson-KFF Health System Tracker
Although most adults are in good health and have health insurance, more than 1 in 4 adults (28%) reported delaying or foregoing healthcare due to cost.
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Krutika Amin @krutika.bsky.social · 08/04/2024
"For too many Americans drugs are unaffordable... [and] having to ration life saving drugs." - linakhanFTC w jonstewart: youtu.be/oaDTiWaYfcM?... Fact check: Looking at #insulin, over 1 in 5 non-elderly adults (18-64 years) with private insurance rationed insulin due to cost.
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Krutika Amin @krutika.bsky.social · 08/04/2024
I'm sure you saw, but in case--these VCI hub use and costs estimates. HHS didn't disclose the exact tag, but could back match a little based on the # of state exchanges and state Medicaid/CHIP programs. My read is that most of the cost (except the federal admin part) is variable on the # of pings.
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Reposted by Krutika Amin
Adrianna McIntyre @adrianna.bsky.social · 05/04/2024
New paper w/Ben Sommers & Rebecca Smith: Looking at self-reported insurance in Census data, we document a big disconnect between (1) "actual" growth in Medicaid (in administrative data) during continuous coverage, (2) self-reported Medicaid coverage, and (3) self-reported uninsurance #healthpolicy
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Krutika Amin @krutika.bsky.social · 07/04/2024
The No Surprises Act prohibits many surprise balance bills, but not all. For more on: -when privately insured people may still be getting surprise balance bills? -what happens next? -what federal resources are available? See #kff brief: www.kff.org/health-costs...
kff.org
What resources are available for privately insured patients who get surprise balance bills? | KFF
Most patients do not know about the new surprise billing protections and likely also do not know of resources available to seek recourse for incorrect medical bills. This brief provides resources to p...
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Krutika Amin @krutika.bsky.social · 07/04/2024
At the time of @kff_org analysis, United Healthcare had 14% of the enrollment, and accounted for nearly a quarter of No Surprises Act federal disputes. healthsystemtracker.org/brief/indepe... #healthpolicy
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Krutika Amin @krutika.bsky.social · 07/04/2024
Relatedly to today's NYT on MultiPlan and $UHG nytimes.com/2024/04/07/u... (from Chris Hamby), Multiplan and United Healthcare are among top 3 entities getting claims disputed through the federal No Surprises Act process: healthsystemtracker.org/brief/indepe... #KFF
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Krutika Amin @krutika.bsky.social · 05/04/2024
🗨️What stood out to you in the 2025 NBPP final rule?
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Krutika Amin @krutika.bsky.social · 05/04/2024
💰User fee decrease in 2025 NBPP has implications for SBMs & SBM-FPs: 1) potentially tougher for SBMs' charges. 2) at the same time, gives room to increase SBM fees. SBM functions tend to be more variable with enrollment and plan participation while @healthcaregov has greater economies of scale.
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Krutika Amin @krutika.bsky.social · 05/04/2024
Mixed premium impact changes in 2025 NBPP: 🖌️Dental routine adult care, in states that do add, would have upward impact, but possibly mixed if lowers other long-run costs 💵Risk adjustment changes: since budget neutral, depends. Some plans will win others will lose by definition
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Krutika Amin @krutika.bsky.social · 05/04/2024
🔽Negative premium impact policies in 2025 NBPP: User fee for @healthcaregov Marketplace plans set at the lowest level ever at 1.5% for FFM and 1.2% for SBM-FPs, down from 2024 (2.2% and 1.8) and initial levels (3.5% and 3.0%). This has a direct➖downward premium impact
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Krutika Amin @krutika.bsky.social · 05/04/2024
🔺Positive premium impact policies in 2025 NBPP: Network adequacy minimum for state Marketplaces (including SBMs and SBM-FPs) plans set to the federal marketplace level starting in 2026. Likely already the case for many states, puts ➕pressure in states not at min federal level.
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Krutika Amin @krutika.bsky.social · 05/04/2024
🧵HHS finalized the 2025 annual regulation (NBPP or Payment Notice) for ACA Marketplaces and individual/small group market. Quick takes on premium impact, and other implications. Rule: www.cms.gov/files/docume... #healthpolicy
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Krutika Amin @krutika.bsky.social · 02/04/2024
How do gross margins vary by health insurance market? See #KFF analysis. *Note: Positive margins do not necessarily translate into profitability since they do not account for administrative expenses or tax liabilities www.kff.org/medicare/iss...
kff.org
Health Insurer Financial Performance in 2021 | KFF
Using health insurer financial data for 2021, we find that Medicare Advantage insurers reported gross margins that were at least twice as high as those reported by insurers in the individual/non-group...
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Reposted by Krutika Amin
Sam Austin @samva.bsky.social · 29/03/2024
Have seen versions of this graph in other spots (maybe from KFF too). Prolonged and persistent implosion of workforce in long‐term care facilities post-pandemic is scary.
Graph showing cumulative ٪ change in health sector employment by setting Feb 2020 to Feb 2024. All selected settings have rebounded and surpassed prepandemuc baseline, except elderly care facilities (~ down 1%) and skilled nursing facilities (down ~ 8٪)
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Krutika Amin @krutika.bsky.social · 28/03/2024
Latest health sector job numbers in charts: -Employment in hospitals and clinics now back to pre-COVID projections -Home- and nursing care jobs have seen higher average wage increases www.healthsystemtracker.org/chart-collec... #KFF #polisky #healthpolicy
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Krutika Amin @krutika.bsky.social · 28/03/2024
During the Trump Administration, short-term limited duration (STLD) health insurance plans were de-regulated and allowed to go on for longer (364 days, up to 3 years renewal). President Biden campaigned on reigning in these so called “junk” plans.
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Krutika Amin @krutika.bsky.social · 28/03/2024
Biden Admin is concerned a lay consumer, searching the web for health insurance likely can't tell whether a health insurance plan will cover their pre-existing conditions or other major health events. See for example this ad--
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Krutika Amin @krutika.bsky.social · 28/03/2024
Biden Admin has finalized rule limiting short-term limited duration (STLD) plans to 4 months instead of up to 3-years. #KFF estimate: 1.2M were buying non-ACA-compliant plans (like grandfathered and short-term plans) in mid-2022, down from 5.7M in mid-2015. www.kff.org/affordable-c... #healthpolicy
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Krutika Amin @krutika.bsky.social · 27/03/2024
KFF State Health Facts link: www.kff.org/state-catego...
kff.org
Affordable Care Act Archives | KFF
This category includes information on state health insurance marketplaces, Medicaid expansion, uninsured individuals and the ACA, and medical loss ratios. Additionally, this category contains informat...
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Krutika Amin @krutika.bsky.social · 27/03/2024
Of the net new #ACA Marketplace sign ups without APTCs (about 140,000), some could be ICHRA enrollees. Hard to put an exact figure on it though. See stats in updated KFF State Health Facts @jaredortaliza.bsky.social @mattmcgough.bsky.social @cynthiaccox.bsky.social #healthpolicy
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Krutika Amin @krutika.bsky.social · 27/03/2024
CMS released 2024 ACA Marketplace plan selections public use files. Total sign ups* tallied 21.4Million. From last year, sign ups with premium help increased by 4.9M and by about 140,000 without APTC. *Thru end of open enrollment for @healthcaregov.bsky.social & SBMs www.kff.org/affordable-c...
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Krutika Amin @krutika.bsky.social · 26/03/2024
6/6 Nevada is one of the states experimenting with public option plans to address health care costs. Compare premiums, enrollment, and other data points for NV vs national avg or other states with *KFF State Health Facts*: www.kff.org/affordable-c...
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Krutika Amin @krutika.bsky.social · 26/03/2024
5/ Commenters on Nevada’s 1332 application noted that reinsurance may not be an effective strategy to increase enrollment or lower premium payments. For example, this comment from CBPP:
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Krutika Amin @krutika.bsky.social · 26/03/2024
4/ Not many arguments for Nevada’s 1332 application, that I saw at a quick glance. CBPP did agree with the general goals of Nevada’s public option plan:
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Krutika Amin @krutika.bsky.social · 26/03/2024
3/ Arguments against Nevada’s application include those by health plans and others saying the cost targets and projections are too high.   For example, Here are a couple comments www.cms.gov/files/docume...
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Krutika Amin @krutika.bsky.social · 26/03/2024
2/ Nevada’s 1332 application was to 1) require Medicaid plans to offer a public option plan on NV’s Marketplace, 2) set a premium reduction target of up to 15% over 4 years for public option plans, and 3) create a reinsurance program. See here: dhcfp.nv.gov/uploadedFile...
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Krutika Amin @krutika.bsky.social · 26/03/2024
Nevada has requested CMS to pause its review of Nevada’s 1332 waiver application which included a reinsurance program and a public option. Letter rescinding the application: www.cms.gov/files/docume... What’s going on? Thread🧵 #healthpolicy
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Dan Diamond @ddiamond.bsky.social · 26/03/2024
Anti-abortion activists resurrected the 1873 Comstock Act, saying it bans abortion drugs by mail. Big takeaway today: Justices Alito and Thomas seem open to the argument. And now they can tee up a roadmap for Trump to crack down on abortion nationwide. www.washingtonpost.com/health/2024/...
washingtonpost.com
Supreme Court focus on Comstock Act suggests potential threat to abortion access
Justices Samuel A. Alito Jr. and Clarence Thomas repeatedly invoked the 151-year-old law Tuesday during oral arguments in an abortion pill case.
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Krutika Amin @krutika.bsky.social · 26/03/2024
CMS estimated projections of total health expenditures from 2010 and 2015 extended out through 2031 indicate that CMS now expects health spending to be $1.9T less than what CMS expected in 2010 and $800B less than 2015 projections. www.healthsystemtracker.org/chart-collec...
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Krutika Amin @krutika.bsky.social · 25/03/2024
The No Surprises Act now protects privately insured patients from balanced bills on many out-of-network items and services, but not all. Explainer: www.kff.org/health-costs... For example--this $97,000 out-of-network air ambulance bill. kffhealthnews.org/news/article... #healthpolicy
kffhealthnews.org
A Mom’s $97,000 Question: How Was Her Baby’s Air-Ambulance Ride Not Medically Necessary? - KFF Health News
There are legal safeguards to protect patients from big bills like out-of-network air-ambulance rides. But insurers may not pay if they decide the ride wasn’t medically necessary.
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Krutika Amin @krutika.bsky.social · 21/03/2024
I spoke to Sarina Trangle at Newsday about UnitedHealthcare and Mount Sinai negotiations, see here: www.newsday.com/business/uni...
newsday.com
Mount Sinai and UnitedHealthcare reach deal
Many Mount Sinai physicians were slated to leave the insurer's commercial network on Friday.
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Krutika Amin @krutika.bsky.social · 21/03/2024
4/ When there are a limited number of providers or hospitals in a region, hospitals/providers have the market power to be the price setters. That can be difficult if there is only one hospital in an area or if it serves a specific population. www.healthsystemtracker.org/brief/policy...
healthsystemtracker.org
Health Cost and Affordability Policy Issues and Trends to Watch in 2024 - Peterson-KFF Health System Tracker
While issues of health care costs and affordability may not be at the forefront of this year’s election, they remain a major concern among the public. Health spending in the United States is projected...
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Krutika Amin @krutika.bsky.social · 21/03/2024
3/ Price transparency data requirements can have some unintended consequences—hospitals find out what competitors are paid and demand higher prices. There’s also potential for vice versa but requirements are fairly new to say how things are going to net. www.healthsystemtracker.org/brief/policy...
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Krutika Amin @krutika.bsky.social · 21/03/2024
2/ Labor wage inflation has put cost pressure on hospitals. Average wages for health care jobs have grown at pace or sometimes faster than other jobs. Reimbursement rates are set in advance and so part of what we’re seeing maybe re-negotiations. www.healthsystemtracker.org/chart-collec...
healthsystemtracker.org
What are the recent trends in health sector employment? - Peterson-KFF Health System Tracker
Along with the rest of the economy, the health sector saw a sharp drop in revenues and employment at the onset of COVID-19 in the spring of 2020. Health services utilization dropped precipitously as p...
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Krutika Amin @krutika.bsky.social · 21/03/2024
1/ Provider and particularly hospitals are a significant driver of health care costs and therefore premiums. If plans want to keep premiums similar yoy, they may take on hospitals. And like any negotiation, each bargaining party tries to hold a hard line. www.healthsystemtracker.org/chart-collec...
healthsystemtracker.org
How has U.S. spending on healthcare changed over time? - Peterson-KFF Health System Tracker
This chart collection explores National Health Expenditure (NHE) data from the Centers for Medicare and Medicaid Services (CMS).
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Krutika Amin @krutika.bsky.social · 21/03/2024
🧵What market forces are at play in the UnitedHealthcare $uhg and Mount Sinai New York contract negotiations? And why are we seeing more of these provider-health plan fights and fall outs of late? #healthpolicy #medSky
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Sam Austin @samva.bsky.social · 20/03/2024
you're on your own to figure all this out (part 143,326)
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Krutika Amin @krutika.bsky.social · 20/03/2024
At a work event, someone mentioned the polio vaccine -- and I very reflexively spat out "H2P". Appropriate or inappropriate conversation interrupter?!? #Pitt #H2P 😆
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Krutika Amin @krutika.bsky.social · 19/03/2024
CMS data shows that about 11,000 complaints were filed through the federal feedback portal established under the No Surprises Act. Report says 248 complaints involved a violation and resulted in $3 million in monetary relief paid #healthpolicy #medsky www.kff.org/health-costs...
kff.org
What resources are available for privately insured patients who get surprise balance bills? | KFF
Most patients do not know about the new surprise billing protections and likely also do not know of resources available to seek recourse for incorrect medical bills. This brief provides resources to p...
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Krutika Amin @krutika.bsky.social · 19/03/2024
To seek recourse, patients would first need to recognize that their plan’s decision was incorrect and that a provider bill is subject to the No Surprises Act. KFF polling found 78% of Americans know little or nothing about the new protections. #healthpolicy #medSky
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Krutika Amin @krutika.bsky.social · 19/03/2024
The No Surprises Act prohibits many balance bills ("surprise billing") for privately insured patients. Balance bills can and do still happen due to: -billing mistakes -not protected under NSA -service is not covered by plan What happens then? See: www.kff.org/health-costs... #healthpolicy
kff.org
What resources are available for privately insured patients who get surprise balance bills? | KFF
Most patients do not know about the new surprise billing protections and likely also do not know of resources available to seek recourse for incorrect medical bills. This brief provides resources to p...
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Krutika Amin @krutika.bsky.social · 14/03/2024
See KFF report on how ACA individual market enrollment has changed in recent years: www.kff.org/private-insu...
kff.org
As ACA Marketplace Enrollment Reaches Record High, Fewer Are Buying Individual Market Coverage Elsewhere | KFF
This analysis looks at how many people are signed up for each type of individual ACA Marketplace coverage—both on- and off-Marketplace and with or without subsidies—as of early 2023 based on federal e...
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