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Medicine and Health Sciences Commons

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University of Louisville

Electronic Theses and Dissertations

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Full-Text Articles in Medicine and Health Sciences

The Impact Of The Patient Protection And Affordable Care Act’S Risk Adjustment Program On Adverse Selection : First Year Case Study., Steven K. Zimmerman Aug 2016

The Impact Of The Patient Protection And Affordable Care Act’S Risk Adjustment Program On Adverse Selection : First Year Case Study., Steven K. Zimmerman

Electronic Theses and Dissertations

In 2014 the Patient Protection and Affordable Care Act (ACA) implemented a risk adjustment program to stabilize premiums and neutralize premiums in the individual health insurance marketplace. This dissertation will examine the impact of the ACA risk adjustment program on adverse selection for one insurer during 2014. This study utilized enrollment and claims data for one insurer and employs graphical analysis to test for adverse selection. Previous studies have been unable to utilize actual insurer data to test for adverse selection in under the ACA risk adjustment program. Until the implementation of the ACA, insurers relied on underwriting methods to …


The Effect Of The Patient Protection And Affordable Care Act On The Medicare Part D Coverage Gap As Reflected In Diabetes Medication Adherence., Jennifer A. Forristal Dec 2015

The Effect Of The Patient Protection And Affordable Care Act On The Medicare Part D Coverage Gap As Reflected In Diabetes Medication Adherence., Jennifer A. Forristal

Electronic Theses and Dissertations

This dissertation involves an evaluation of the effect of the Patient Protection and Affordable Care Act (ACA) on diabetic medication adherence for mail order utilizers over 6 years as the Medicare Part D coverage gap begins to close. The study had 3 objectives: 1) to evaluate diabetes medication adherence of health plan members before they reach the coverage gap and then while they are in the coverage gap, 2) to compare diabetes medication adherence between two similar groups with differing benefit structures, one group with a gap in coverage as opposed to a group with no benefit changes within the …