Healthcare Costs and Spending Arriving at a Fair Price in the Medicare Drug Price Negotiation Program: Considerations from Other Countries (Health Affairs Forefront) John K. Lin, James I. Barnes, Jalpa A. Doshi, Salah Ghabri, Peter Kolominksy-Rabas, Brian O’Rourke The Centers for Medicare and Medicaid Services (CMS) are slated to begin negotiating drug prices for a subset of Medicare drugs soon, due to the Inflation Reduction Act (IRA) of 2022. Recognizing the subjectivity involved in determining fair drug prices, this article highlights the authors’ perspectives on CMS’ current strategic shortcomings and analyzes …

Healthcare Prices and Cost In An Era Of Premium And Provider Price Increases, State Employee Health Plans Target Key Cost Drivers (Health Affairs Forefront) Sabrina Corlette, Karen Davenport Employer-sponsored health insurance premiums have outpaced inflation and are poised for significant rate hikes this year. State Employee Health Plans have been in a prime position to address health care costs. Administrators of these plans identified reference pricing, tiered network plans, and multi-payer purchasing initiatives as having promising results in addressing cost drivers. The Joint Distribution Of High Out-Of-Pocket Burdens, Medical Debt, …

As we prepare to transition to the summer, this month is an opportune time to examine the impacts of potentially a new season in the health care market. Researchers noted that not only is there a rise of geographically distant mergers even as rural hospitals struggle to maintain profitability, but also that private equity is a new major financier of the health care market. On the other hand, California hopes to increase competition with Golden Choice, a state-run public option. Federally, price transparency efforts could be a step towards creating …

The Source on Healthcare Price & Competition is thrilled to announce the launch of the newest interactive key issue pages in Provider Rate Regulation. Along with a report published in Frontiers in Health Services, this series of key issue pages aim to provide state policymakers with a roadmap of effective strategies to address rapidly increasing prices. In many markets, where existing competition are insufficient to constrain the pricing power of dominant insurers and providers, policymakers need to consider options to directly limit the unrelenting increase of healthcare prices that threatens the affordability of health care for Americans. With support …

This month, we are pleased to highlight new publications co-authored by The Source-affiliated health policy researchers and scholars, discussing 1) the potential benefits of all-payer hospital global budgets, and 2) the legal viability and policy effects of state public option health plans. Additionally, we examine articles covering research on 3) hospital service offerings based on ownership type, 4) the correlation between hospital prices and patient outcomes, 5) data sources within California’s physician practice landscape, and 6) the labor market impact of hospital mergers.   Healthcare Reform and Cost Containment High …

In a new paper published in the Harvard Journal on Legislation Volume 59, Issue 1, The Source’s Jaime King and Katie Gudiksen, together with Erin Fuse Brown, discuss state public option proposals from 2010–2021, including from states like Nevada, Colorado, and Washington. In examining the three main models—(1) Medicaid Buy-In Public Options; (2) Marketplace-Based Public Options; and (3) Comprehensive Public Options—the paper considers potential challenges to these state public option plans and whether they are legally viable and “worth it” for states to pursue, given the goal of improving healthcare …

This month, we are pleased to highlight two recent publications co-authored by health policy researchers from The Source. We specifically examine articles and reports discussing market consolidation including 1) viable practices state policymakers can implement to address provider market power, 2) a critical look at legislation targeting concentrated markets, 3) statistical reports analyzing health insurance market consolidation, and 4) a study on the quality of care in post-merger rural hospitals. In addition, we cover articles that examine public option health plans recently enacted in some states, proposals to improve compliance …

As states like Nevada, Colorado, and Washington push forward with their state public option efforts, a new article in New England Journal of Medicine, co-authored by Erin Fuse Brown and The Source’s Katie Gudiksen and Jaime King, takes a closer look at the key provisions of each of the plans. The article discusses potential challenges to these state public option plans and most importantly, whether they can effectively improve healthcare coverage and affordability. Listen to Erin Fuse Brown discuss lessons from these states in a podcast for NEJM.

This month, our round-up proudly features a new issue brief written by our Source colleagues that discuss what state regulators need to strengthen state antitrust laws and prevent further healthcare provider consolidation. Also highlighted in this month’s round-up are studies on the potential impact of the federal No Surprises Act on health care prices, state-level strategies to reduce health care spending, better methods to assess policy-relevant financial information of hospitals, a grassroots push towards the public option, and industry trends and implications in the pharmacy market.   Market Competition/Consolidation In …

The COVID-19 pandemic has caused the American healthcare system to undergo drastic changes in a matter of months. Coupled with a new presidential administration, the health care system is likely to evolve. The Biden administration has already taken action on a number of key health policy areas in which significant changes might occur. In light of these changes, health policy experts are thinking about what health care will look like in the post-pandemic world. This month’s Roundup covers new research on 1) the impact and benefits of the No Surprises …