May 2006
Coalition to Protect Access to Affordable Health Insurance
Lewin contact: John Sheils
In this study, The Lewin Group estimated the cost and coverage impacts of the Health Insurance Marketplace Modernization and Affordability Act (S. 1955) sponsored by Senator Enzi of Wyoming and adopted by the Health, Education, Labor and Pension Committee of the U.S. Senate. The bill would establish a new optional regulatory standard that insurers in the small group market could choose to follow instead of state regulations. This standard would permit carriers to set rates according to the National Association of Insurance Commissioner’s (NAIC) 1993 Small Group Rating Model legislation, which permits premiums to vary with health status and other factors. Carriers electing this option also would be exempt from state mandated benefits requirements.
Client Area: Associations
Expertise Area: Health Reform
April 2006
The Medicaid Health Plans of America and the Association of Community Affiliated Plans
National Medicaid expenditures have risen at an average of 8.2 percent annually since 1995, outpacing states' revenue growth and placing enormous pressure on states to implement effective cost containment programs. The Medicaid Health Plans of America and the Association of Community Affiliated Plans jointly engaged The Lewin Group to quantify the savings that can be realized through state Medicaid agencies entering into capitation contracting with Medicaid managed care organizations. The report found, among other key points, that up to $83 billion can be saved over ten years if the capitation model were immediately applied to all appropriately suited Medicaid funds.
Client Area: Associations
Expertise Area: Medicaid and CHIP
April 2006
Pennsylvania Health Care Association
The Pennsylvania Health care Association commissioned The Lewin Group to conduct a study that would help answer the following questions:
What long-term care services will be needed and available over the next ten years?
What is the current supply of long-term care services in the Commonwealth?
What will the demand for long-term care services in the Commonwealth be over the next 10 years?
Given the current supply of long-term care services and the estimated rate of growth in the demand for these services, what are the trade-offs between providing nursing home care versus providing home- and community-based services?
This report is the second in a series of reports commissioned by the Pennsylvania Health Care Association. The first report provides information on the economic impact of nursing homes on the Commonwealth.
Client Area: Associations
Expertise Area: Aging and Disability
April 2006
Healthcare Leadership Council
Lewin contact: Lisa Chimento
This study, commissioned by the Healthcare Leadership Council, analyzes savings available to Medicare beneficiaries with common chronic conditions who enroll in a Prescription Drug Plan (PDP). The five chronic conditions studied are arthritis, diabetes, hypertension, osteoporosis and respiratory illness. 84 percent of Medicare beneficiaries report having at least one of these most common diagnoses. Lewin finds that, nationwide, beneficiaries can save 43 to 58 percent by enrolling in one of the 5 PDPs with the lowest costs.
The executive summary presents information at a national level by chronic condition. Available in separate files are state level findings for Alabama-Kentucky, Louisiana-North Dakota, and Ohio-Wyoming. Also available in separate files are the appendices which provide additional detailed data for Alabama-Kentucky, Louisiana-North Dakota, and Ohio-Wyoming.
Client Area: Associations
Expertise Area: Chronic Disease / Cost of Illness, Medicare
January 2006
Association for Community Affiliated Plans; Medicaid Health Plans of America
Lewin contact: Lisa Chimento
The Association for Community Affiliated Plans and the Medicaid Health Plans of America retained The Lewin Group to conduct a study of the ways that states have implemented rules from the Balanced Budget Act of 1997 regarding actuarial soundness, in order to identify both best practices and continuing areas of concern. Lewin developed a survey to gather information from states and health plans on current rate-setting practices. This report presents the results of the survey.
Client Area: Associations
Expertise Area: Medicaid and CHIP
January 2006
National Health Council
Lewin contact: Lisa Chimento
The purpose of this study is to estimate the potential savings offered throught the new Medicare prescription drug benefit to Medicare beneficiaries living with chronic conditions. For this study, The Lewin Group examined drug spending data for Medicare beneficiaries who face a decision whether to enroll in the Medicare drug benefit. The study focuses primarily on beneficiaries with chronic conditions because these beneficiaries have higher average drug costs than beneficiaries without chronic conditions. The specific chronic conditions included in this study are: Alzheimer's, arthritis, chronic obstructive pulmonary disease, diabetes, heart disease, hypertension, mental disorder, osteoporosis, and Parkinson's.
Client Area: Associations
Expertise Area: Medicare
January 2006
Louisiana Hospital Association
In an effort to develop a unified policy framework for redesigning Louisiana’s healthcare services in the wake of Hurricane’s Katrina and Rita, the Louisiana Hospital Association engaged The Lewin Group to conduct a series of interviews with healthcare, education, business and government leaders across the state to gather information regarding both short-term and long-term needs of the industry. The resulting report describes a series of proposed federal and state policy initiatives that would facilitate cost-effective redesign of Louisiana's healthcare delivery system.
Client Area: Associations
Expertise Area: Health Reform
January 2006
Dietary Supplement Education Alliance
The Lewin Group was commissioned by the Dietary Supplement Education Alliance to (1) critically review the research literature for two dietary supplements for which an association has been shown between intake of the supplement and reduced risk of a disease that can lead to a loss of an older person's independence, and (2) develop estimates of potential health care savings that could result from daily use of the supplement. Supplement/disease combinations in this study are omega-3 fatty acids and coronary heart disease, and lutein/zeaxanthin and age-related macular degeneration.
Client Area: Associations
Expertise Area: Evidence-Based Medicine / HTA
August 2005
Pharmaceutical Care Management Association
Mail-service pharmacies—technologically advanced facilities operated primarily by pharmacy benefit managers (PBMs)—dispense millions of prescriptions each year with a high degree of accuracy and cost efficiency. This study seeks to quantify the savings associated with the mail-service pharmacy distribution channel being used to full potential.
Client Area: Associations
July 2005
Advanced Medical Technology Association (AdvaMed)
Lewin contact: Clifford Goodman
The Lewin Group was commissioned by The Advanced Medical Technology Association (AdvaMed) to examine certain key aspects of the US diagnostics industry. This document is intended to: a) educate and inform various audiences about diagnostics and the industry that develops them; b) describe the value of diagnostics through the health care continuum and the broader health system; c) describe the technology evolution in diagnostics and potential of these technologies to alter clinical practice; d) identify and describe the hurdles to product development and dissemination; e) identify changes necessary to overcome these challenges; and f) define actionable recommendations for enabling clinicians, patients, provider institutions, payers and other stakeholders to better realize the value and potential of diagnostics to improve health care delivery, individual health and the public’s health.
Client Area: Associations
Expertise Area: Evidence-Based Medicine / HTA
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