surprise billing
p39, (and chapter 6 too), reading a note about a 2015 study that found, 30% of plans on federal marketplqce, wow, without any emergency physician coverage?!
so all those would be out of network.
cost sharing
p40, cost sharing like HDHP, intended to reduce cost by getting people to shop around more. RAND, findings, less money spent but not by shopping around but by getting less care .
managed care
p41, referrals and prior authorizations, to pay less for services as a respknse to more services and higher costs in 1970s and 1980s?? HMOs. And Medicare Advantage.
More paperwork for clinicians. And more hoops for patients.
churn
p42, hmm, plan churn, disincentivizes insurers from helping with preventative care! some other insurer getting bentfit of better outcome. yikes.
MA: 8% to 33% churn.