Increases in health care spending are important to track because they have a significant impact on the economy and the overall well-being of society. High health care spending can lead to increased health care costs for individuals and businesses, higher taxes, and decreased access to care for some people. Monitoring spending trends helps policymakers and stakeholders make informed decisions about how to allocate resources and improve the health care system.

Many people remain uninsured despite Medicaid and CHIP because these programs have eligibility requirements based on income, citizenship status, and other factors. Some individuals do not qualify for these programs, while others who do may not enroll due to lack of awareness or difficulty navigating the enrollment process. Additionally, some states have not expanded their Medicaid programs under the Affordable Care Act, leaving some individuals with limited access to coverage.

The individual market for health insurance is more expensive than buying insurance as part of a group because group plans spread the risk over a larger pool of individuals, making it easier for insurers to manage costs. Individuals who buy insurance on their own bear more of the financial risk, making it more expensive for them.

Managed care companies are organizations that contract with health insurance companies to provide health care services to their enrollees. There are three main models of managed care: HMOs, PPOs, and POS plans.

HMOs (Health Maintenance Organizations) require enrollees to choose a primary care physician who coordinates all their care. HMOs often have limited networks of providers and require referrals to see specialists. Pros: lower out-of-pocket costs, coordinated care. Cons: limited provider choice, need for referrals.
PPOs (Preferred Provider Organizations) allow enrollees to see providers both in and out of network, but offer greater benefits for in-network providers. Pros: more provider choice, less restrictions on care. Cons: higher out-of-pocket costs for out-of-network care.
POS (Point of Service) plans are a hybrid of HMOs and PPOs. Enrollees typically choose a primary care physician, but can also see specialists without a referral. Pros: more provider choice, less restrictions on care than HMOs. Cons: higher out-of-pocket costs than HMOs.
The advantage for providers in joining a managed care network is increased patient volume and stability in reimbursement. Managed care organizations often negotiate higher reimbursement rates with insurance companies, providing a financial incentive for providers to join. Providers also benefit from having a more predictable patient flow, as managed care organizations steer patients towards in-network providers. The disadvantages include dealing with managed care bureaucracy, increased administrative work, and the potential for decreased autonomy in treating patients.