Simplifying Administration of Health Insurance

Mark Merlis
Health Policy Consultant

The high administrative costs of the U.S. health insurance system have been a focus of discussion for decades. Simplifying Administration of Health Insurance finds ways to define and classify administrative costs, both of insurers and of other participants in the system, and summarizes the fragmentary estimates of how large these costs are. It discusses current efforts to reduce administrative costs, many of which have focused on standardizing and simplifying transactions among insurers, providers, and employers. Finally, it considers how various reform proposals, whether or not directly targeted at administrative costs, might reduce—or add to—the complexity of the current system.

Click here to download the full working paper, commissioned by a joint study panel of the National Academy of Social Insurance and the National Academy of Public Administration on Administrative Solutions in Health Reform. For a list of other papers and study panel members, click here. The project is funded by the Robert Wood Johnson Foundation.

Restructuring Health Insurance Markets

Elliot K. Wicks
Senior Economist, Health Management Associates

Restructuring Health Insurance Markets examines six structural changes that could expand health insurance coverage, with special focus on the administrative issues: changes in rating rules, high risk pools, standard benefit plans, reinsurance, Section 125 plans, and insurance exchanges. It considers what benefits these changes might produce, how they can be most effectively structured, and how they can be implemented. From an administrative standpoint, it is critical that any set of policies be considered as a whole, with careful attention to their interactions, both to enhance their chances for success and to avoid unnecessary administrative burdens and duplication.

Click here to download the full working paper, commissioned by a joint study panel of the National Academy of Social Insurance and the National Academy of Public Administration on Administrative Solutions in Health Reform. For a list of other papers and study panel members, click here. The project is funded by the Robert Wood Johnson Foundation.