Editor’s Note: As the historic antitrust lawsuit against healthcare giant Sutter Health heads to trial, The Source will feature a series of legal analyses, including revisiting the complaints and summary judgment order, to bring readers up to speed in this one of a kind case. The trial is set for September and expected to last around 12 weeks. Continue to follow The Source Blog as we bring the latest first-hand coverage and analysis in this case.    On August 6, the California superior court heard arguments on which antitrust analysis …

Happy August! Even as the summer winds down, there is no waning of health policy literature. In this month’s Source Roundup, we take a look at academic articles and studies that analyze 1) potential prescription drug savings from generics and biosimilars, 2) the need for price transparency, and 4) a multitude of efforts in health system reform.   Potential Prescription Drug Savings from Generics and Biosimilars As prescription drug pricing continue to capture the nation’s attention, Stacie B. Dusetzina et al. take a dive into cost discrepancies between brand name …

State enforcement is the theme of the month in healthcare antitrust. A panel of antitrust experts at a recent Antitrust Symposium hosted by UC Hastings College of the Law discussed how exclusionary contracts and anticompetitive conduct by players in both the provider and pharmaceutical markets hinder competition and drive up healthcare prices. This edition of Litigation and Enforcement Highlights takes a look at current anticompetitive practices of providers and PBMs and the ensuing state regulatory efforts to address them.   A Tale of Two Coasts in Provider Market Enforcement As …

On Thursday, April 4, The Source attended the “Antitrust in the New Millennium Symposium” hosted by UC Hastings College of the Law.  This blog focuses on the session “New Antitrust and Healthcare”, moderated by The Source Board member and UC Hastings Professor Thomas Greaney, and featuring the panel of, notably all women, UC Hastings Professor Robin Feldman, California Senior Assistant Attorney General Kathleen Foote, and American Antitrust Institute (AAI) President Diana L. Moss.   What drives rising healthcare prices?  Perhaps it stems from anticompetitive conduct in the provider market.  Perhaps the convoluted …

Avoid driving, get help instantly. That’s the premise of telehealth. Telehealth, under California law, is defined as “the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care.”[1] One study has shown that the use of telehealth, in California, has been found to save a patient 278 miles in driving, 4 hours in time, and $156 in direct travel costs per consultation.[2] As such, telehealth has been used as an …

Happy New Year! We hope this year is filled with good health (policy) and much happiness! In this roundup, we look at (1) proposals to address healthcare costs and competition, (2) changes to section 1332 waivers, (3) rising healthcare costs, premiums, and deductibles, and three articles specifically about telehealth from a special Health Affairs issue.   Proposals to Address Rising Healthcare Costs and Lack of Competition On December 3, the U.S. Department of Health and Human Services (HHS), in collaboration with the Departments of the Treasury and Labor, released Reforming …

Happy November! We hope you are enjoying football season and preparing for turkey! In this edition of the Source Roundup, we cover five academic articles and reports from October. The topics this month include (1) the popularity of telemedicine for employers and employees, (2) an integrated health care system that combines ACO and bundled payment, (3) health spending growth in the coming years, (4) Maryland’s new initiative reduced hospital utilization and costs, and (5) how to remedy recent generic drug price hikes.   Telemedicine Is More Widely Available, But Take-up …

A Texas high school teacher recently made headlines after getting a $108,951 bill when a heart attack sent him to an out-of-network hospital. The ambulance rushed Drew Calver to the nearest emergency center, which his insurance did not cover, leaving him with an astronomical surprise medical bill. Unfortunately, surprise medical bills are becoming a ubiquitous part of health care in America. The question is: why? Most people have insurance, but insurance doesn’t cover everything. So when Calver was treated at an out-of-network facility, his insurance paid only $55,840 towards the …

Happy May! In this edition of the Source Roundup, we cover four academic articles and reports from March and April. The topics this month include: 1) the unfilled promise of price transparency to encourage price shopping, 2) FDA’s actions on prescription drug prices, 3) the phenomenon of overpayment for prescription drugs, and 4) results of Maryland’s All-Payer global hospital budgeting program.  Unfulfilled Promise of Price Transparency to Encourage Price ShoppingIn Promise and Reality of Price Transparency, a health policy report published by the New England Journal of Medicine, authors Ateev Mehrotra, Michael …

February brought us a number of interesting articles and reports on healthcare price and competition issues. This month’s Roundup covers publications about 1) projected growth in national healthcare expenditures|2) ACA state marketplace competition|3) the relationship between payment reform and provider consolidation|and 4) the impact of the ACA on individual’s ability to buy insurance. We hope you enjoy! Projected Growth in National Health Expenditures Health Affairs published a report on National Health Expenditure Projections: 2016 – 25 by Sean P. Keehan and colleagues. According to the report, healthcare spending will continue …