Value-Based Payment
The Source Roundup: March 2023 Edition
Rachel Ng, Student Fellow March 1, 2023
This month’s Roundup focuses on articles and reports examining price transparency efforts at both the state and federal levels as well as new recommendations for policymakers on effective healthcare cost containment strategies. States continue to address the lack of knowledge available to the public with all-payer claims databases. Federally, the implementation of new price transparency rules requiring reporting from health care providers and insurers have been examined for compliance and limitations. In addition to price transparency, to get to the bottom of healthcare affordability concerns, researchers and experts are suggesting …
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The Source Roundup: January 2023 Edition
Amy Y. Gu, Managing Editor January 3, 2023
Happy New Year, Source Readers! We kick off 2023 with highlights of some reports and articles that you may have missed from December. In surprise billing protection efforts, the implementation of the No Surprises Act is hitting unexpected backlogs in the IDR process, while the loophole of ground ambulance surprise bills also warrants further policy attention. Reports on healthcare spending and out-of-pocket costs suggest that healthcare is becoming less affordable as out-of-pocket costs continued to rise. Lastly, a pair of studies on value-based payment models reveal flaws in the systems …
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California Health Care Quality and Affordability Act (AB 1130) Passes Assembly, On Path to Creating Healthcare Cost Commission in California
Mallory Warner, Health Policy Research Fellow July 15, 2021
In February of this legislative session, California Assemblymember Jim Wood introduced AB 1130, titled the California Health Care Quality and Affordability Act. Wood was prompted to draft AB 1130 when a 2020 California Health Care Foundation poll found that 84% of Californians surveyed cited health care affordability as an extremely or very important issue to them.[1] The bill would establish the Office of Healthcare Affordability (the “office”) within the Office of Statewide Health Planning and Development (OSHPD) and be tasked with analyzing health care markets for cost trends and drivers …
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The Source Roundup: April 2021 Edition
Erin Livinghouse, Student Fellow April 1, 2021
Happy April! This month’s roundup centers on articles and reports that discuss: 1) healthcare markets and competition; 2) payment reform, and 3) healthcare costs, and 4) price transparency. Healthcare Markets and Competition In a piece published in the Harvard Business Review titled The Pandemic Will Fuel Consolidation in U.S. Health Care, Lovisa Gustafsson and David Blumenthal, researchers at the Commonwealth Fund, predict that mergers of key players in the U.S. healthcare system will continue as a result of provider financial challenges during the COVID-19 pandemic. While the Federal Trade …
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Health Affairs Blog Posts Highlight the Database of State Laws Impacting Healthcare Cost and Quality
Amy Y. Gu, Managing Editor January 14, 2021
The Source kicked off the New Year with a trio of blog posts in the Health Affairs Blog that highlights the Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ). The SLIHCQ Database was developed in partnership with the Catalyst for Payment Reform (“CPR”) and is an interactive tool that hosts ongoing state legislative efforts to implement healthcare reform. It is intuitively designed to allow policymakers and other stakeholders to customize and filter their searches by key issue and state. In collaboration with CPR, The Source Executive Editor Jaime …
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California Budget Watch (Part 4 of 4): The Legislature Implements Major Healthcare Reforms in Trailer Bills SB 78 and SB 104
Sammy Chang, Health Policy Researcher August 30, 2019
Last month, we recapped the appropriations allocated to healthcare reform in the 2019 California Budget. These budget allocations, however, do not provide much guidance on how the money should be spent. Trailer bills provide the statutory language to implement the budget. With the enacted 2019 budget, the Governor signed two healthcare trailer bills passed by the Legislature, SB 78 and SB 104. In this post, we dissect these trailers bills which create and implement various programs impacting healthcare access and costs. What are Trailer Bills? SB 78 and SB …
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California Budget Watch 2019 (Part 2 of 4): Compromise! Five Quick Insights into AB 74 – The Legislature’s Budget Act of 2019
Sammy Chang, Health Policy Researcher June 24, 2019
On June 13, using the Governor’s May Revise as a starting point, the Assembly and Senate adopted AB 74, the Budget Act of 2019, and sent it to the Governor. This bill provides in detail the Legislature’s compromise of the proposals from the Assembly, Senate, and the Governor. While this bill only provides the appropriation and not the full language of implementation, the proposed budget provides a great preview for what health reforms are in store for California. To better digest specifics of this budget compromise, we’ll break this down …
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The Source Roundup: May 2019 Edition
Tiffany Wang, Student Fellow May 1, 2019
Happy May! We hope you’re enjoying the longer, sunnier days of spring. In this edition of The Source Roundup, we survey articles and reports that discuss 1) health system consolidation’s impact on healthcare prices and quality, 2) the new federal price transparency rule, and 3) cost-containment strategies from various fronts. More Evidence of Hospital Market Concentration’s Negative Impact on Competition and Healthcare Costs Two articles this month reinforced the principle that protecting access to affordable healthcare requires strong antitrust enforcement policies to ensure adequate competition among hospitals and hospital systems. …
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Innovations in State Medicaid Programs to Control Prescription Drug Costs
Katie Gudiksen, Senior Health Policy Researcher March 7, 2019
Medicaid serves nearly one in five Americans, including many with chronic conditions, and purchases about 10% of total prescription medications dispensed in the U.S.[1] From 2013 to 2016, Medicaid’s nationwide drug spending increased almost 50%, from $22.4 billion to $33.4 billion.[2] Medicaid programs consume an increasing percentage of state budgets and threaten to overtake funding for other programs like education and infrastructure.[3] In 2018, the National Association of State Budget Officers (NASBO) estimated that Medicaid accounted for nearly 30% of total state spending and is the fastest growing component of …
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The Source Roundup: June 2018 Edition
Source Fellow June 1, 2018
By: Megan O’Leary, Student Fellow Happy June! In this edition of the Source Roundup, we cover five academic articles and reports from April and May. The topics this month include: 1) barriers for generics to lower specialty drug prices, 2) a call to reform pharmaceutical systems in the United States and Canada, 3) efforts by states to stabilize the individual market, 4) Vermont’s push for community-driven health care reform, and 5) antitrust lawsuits in the pharmaceutical industry. Barriers for Generics to Lower Specialty Drug Prices The Health Affairs article Generic …
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