Medicaid Expansion, Payer Oversight Seen as Vital to Healthcare Reform

Christopher Cheney, for HealthLeaders Media , March 25, 2014

The report calls for "effective oversight of private insurance plans" and Schoen says effective regulation of insurers is a key factor in the national healthcare reform effort because they are creating the provider networks that form the foundation for insurance policies.

"They are agents, and they are organizing care systems for us," she said. "We're relying on private insurers to provide us with options, and we want to make sure they do a good job… This is really a chance for them to prove themselves."

"Comprehensive, decent coverage" for all Americans is in the interest of hospitals and physicians, Schoen said.

The practical benefits for providers include an overall improvement in patient health that will drive down healthcare costs as well as less bill collection activity, she said.

'Enormously Complicated Product'
Dr. David Blumenthal, president of the Commonwealth Fund, speaking on the call, said that reforms introduced under the PPACA offer both opportunities and challenges for consumers, who are expected to play a pivotal role in the evolving health insurance marketplace.

"For the first time, we have a transparent market," Blumenthal said. "People have the ability to see what's offered and to make a choice."

But the choice is not an easy one, especially for consumers who have never had health insurance before, he said. "Insurance is an enormously complicated product," Blumenthal said. He noted that many who decided against obtaining health insurance this year on the PPACA exchanges "weren't sure whether the plans were right for them."

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