Insurance coverage of health care expenses determines access to care, quality of care, and spending on care. Insurance policies change rapidly in response to changing need for care and technologies and costs of care. HPI has long had a major focus on studying impacts of private and public insurance policies on how and by whom health services are used, and on their costs and clinical consequences. In current work, Drs. Garabedian, Lu, Ross-Degnan, Wagner, and Zhang, and, in collaboration with former HPI faculty member Dr. Frank Wharam, are evaluating the impacts of high deductible insurance coverage and Preventive Drug Lists that reduce medication cost sharing on diabetes care, acute complications, and long-term clinical outcomes as part of the Natural Experiments in Translation for Diabetes (NEXT-D) Network, a national consortium funded by CDC and NIDDK now in its third 5-year funding period. Dr. Alison Galbraith leads work on the impact of these coverage policies among families with persistent asthma and Drs. Wharam and Lu lead work examining their impacts among patients with bipolar illness. HPI researchers also study impacts of insurance policies on cancer care.
Drs. Galbraith and Garabedian lead work on the impact of Affordable Care Act Marketplace policies on enrollee characteristics, health care use, and costs. Dr. Garabedian has examined enrollment and care during Special Enrollment Periods for ACA Marketplace plans. Dr. Galbraith has explored political orientation as a predictor of marketplace participation. Dr. Garabedian also leads a study assessing changes in quality of care and costs associated with Benevera Health, an innovative joint venture of Harvard Pilgrim Health Care with a network of New Hampshire health care providers.