therapies and level of incorporation of new costs into future plan coverage. The sustainability of current financing mechanisms varies by payer segment, profitability, and size; smaller plans and Medicaid are likely to be impacted first. Government reinsurance, commercial reinsurance, and stop-lossinsurance backstop current reimbursement models, dampening the need for urgent action. The tipping point
Modeling Employer Self-Insurance Decisions after the Affordable Care Act To present a microsimulation model that addresses the methodological challenge of estimating the firm decision to self-insure. The model considers the risk that the firm bears when self-insuring and the opportunity to mitigate that risk by purchasing stop-lossinsurance. The model makes use of a structural, utility