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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)
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-- 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
- COVID-19 Crisis
- 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 Care Cost Institute
A Multi-Payer Analysis of Health Care Spending in North Carolina
June 30, 2020
U.S. Department of Justice & The Federal Trade Commission
Vertical Merger Guidelines
June 30, 2020
Kaiser Family Foundation
State Efforts to Expand Medicaid Coverage & Access to Telehealth in Response to COVID-19
June 22, 2020
Journal of Health Politics, Policy and Law
The Affordable Care Act’s Missing Consensus: Values, Attitudes, and Experiences Associated with Competing Health Reform Preferences
June 19, 2020
Journal of Health Politics, Policy and Law
Costs versus Coverage, Then and Now
June 19, 2020
BMJ
Spending and quality after three years of Medicare’s bundled payments for medical conditions: quasi-experimental difference-in-differences study
June 17, 2020
Urban Institute
Effects of Medicaid Health Plan Dominance in the Health Insurance Marketplaces
June 17, 2020
The Source on Healthcare Price and Competition
Preventing Anticompetitive Healthcare Consolidation: Lessons from Five States
June 15, 2020
Milbank Memorial Fund
Electronic Consultations (eConsults): A Triple Win for Patients, Clinicians, and Payers
June 9, 2020
NEJM
Lower Prices and Greater Patient Access — Lessons from Germany’s Drug-Purchasing Structure
June 4, 2020
Coverage
Understanding medicaid and eligibility: a state-by-state guide
June 2, 2020
Health Affairs
Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016
June 1, 2020
Health Affairs
Incorrect Provider Directories Associated With Out-Of-Network Mental Health Care And Outpatient Surprise Bills
June 1, 2020
Washington Monthly
Can COVID-19 Get Congress to Finally Strengthen U.S. Antitrust Law?
June 1, 2020
RAND
Public Options for Individual Health Insurance
May 28, 2020
NASHP
50-State Scan of State Certificate-of-Need Programs
May 22, 2020
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