Confronted with conflicting pressures to stem double-digit premium increases and provide unfettered access to care, health plans are developing products that shift more financial and care management responsibilities to consumers, according to findings from the Community Tracking Study. Plans are...

In recent years, health plans have developed measures of health service resource use to assess efficiency of care physicians and other providers deliver primarily relying on tools commonly known as "episode groupers." This report investigates the use of episode grouper-based measures in the...

Health plans and employers rarely work together to address racial and ethnic health care disparities in the workforce. However, these collaborations can strengthen programs to reduce disparities. This policy brief draws on interviews with large employers, health plan representatives, government...

This brief analyzes risk selection over time in Massachusetts' Commonwealth Care program, which serves low-income adults ineligible for Medicaid, much like a Basic Health Plan under the Affordable Care Act. The authors offer lessons for other states considering whether to form a Basic Health...