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Key Issues
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HEALTHCARE MARKETS
- Provider Network
-- Telehealth or Telemedicine
-- Scope of Practice
-- Any Willing Provider
-- Network Adequacy
-- Tiered Network or Narrow Network
- Competition
-- Antitrust Enforcement
-- Healthcare Consolidation
-- Most Favored Nation (MFN)
-- Certificate of Need (CON)
-- Certificate of Public Advantage (COPA)
-- Anti-Steering or Anti-Tiering
-- Non-Compete Provision
-- Price Manipulation
-- Competitive Bidding
-- Trade Secret
- Rate Regulation
- ACA Marketplace
HEALTHCARE COSTS
- Cost Containment
-- Shared Savings or Right to Shop
-- Reference Pricing
-- Prior Authorization
-- Utilization Review
- Price Gouging
- Cost-Sharing or Out-of-Pocket Costs
- High Deductible Health Plan (HDHP)
- Health Savings Account (HSA) or Health Reimbursement Account (HRA)
- Benefit Design
- Provider Payment
-- Value-Based Payment
-- Bundled Payment
-- Global Payment or Global Budget
-- Capitation
-- Population-Based Payment
-- Shared Risk or Risk-Based Payment
-- Facility Fee
HEALTHCARE SYSTEM REFORM
- Single Payer or Multi-Payer
- Public Option
- Delivery Reform
- Quality or Value-Based Reform
- Managed Competition
- Accountable Care Organization (ACO)
- Medicaid Reform or Medicaid Waiver
- Affordable Care Act (ACA)
- Federal Reform Effort
PRICE AND QUALITY TRANSPARENCY
- All-Payer Claims Database (APCD)
- Gag Clause or Non-Disclosure Agreement
- Surprise Billing or Balance Billing
- Quality Measure
PHARMACEUTICALS
- Drug Pricing
- Drug Formulary
- Pharmacy Benefit Manager (PBM)
- Pharmacy Regulation
-- Clawback Restriction
- Biosimilar or Generic Competition
-- Generic Competition Block or Delay
- Therapeutic Substitution
- Medicaid Pharmaceuticals
- Medicare Part D
- 340B Drug Pricing Program
- Drug Importation
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Start Date
End Date
Health Affairs
National Health Expenditure Projections, 2019–28: Expected Rebound In Prices Drives Rising Spending Growth
March 24, 2020
The Urban Institute
Estimates of the Implications of Public Option and Capped Provider Payment Rate Reforms
March 18, 2020
JAMA
Changes in List Prices, Net Prices, and Discounts for Branded Drugs in the US, 2007-2018
March 17, 2020
Center for Medical Economics and Innovation
Promoting Biosimilar Competition to Reduce Patients’ Out-of-Pocket Costs
March 17, 2020
Kaiser Family Foundation
Potential costs of coronavirus treatment for people with employer coverage
March 13, 2020
Brookings Institute
A Proposal to Cap Provider Prices and Price Growth in the Commercial Health-Care Market
March 10, 2020
OSHPD
Health Care Payments Data Program: Report to the Legislature
March 9, 2020
JAMA
Promoting Health Care Transparency via State Legislative Efforts
March 9, 2020
Journal of Medical Systems
Price Transparency: Empowering Patient Choice and Promoting Provider Competition
March 5, 2020
NCMJ
The Evolution and Impact of Hospital Price Transparency in North Carolina
March 5, 2020
The Commonwealth Fund
How the Massachusetts Health Policy Commission Is Fostering a Statewide Commitment to Contain Health Care Spending Growth
March 5, 2020
Health Affairs
Did the Affordable Care Act Lower Financial Barriers to Health Care?
March 3, 2020
Health Affairs
A Pathway To Consumer-Driven Universal Coverage
March 2, 2020
Health Affairs Blog
The ACA And The Courts: Litigation’s Effects On The Law’s Implementation And Beyond
March 2, 2020
Health Affairs
How The ACA Reframed The Prescription Drug Market And Set The Stage For Current Reform Efforts
March 2, 2020
Health Affairs
Building On The Gains Of The ACA: Federal Proposals To Improve Coverage And Affordability
March 2, 2020
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