THE SOURCE BLOG

This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Kansas state page. Kansas was one of the first states to mandate an all-payer claims database (APCD). In operation since 2010, the Data Analytic Interface (DAI) is maintained by the Kansas Department of Health and Environment (KDHE) and the Division of Health Care Finance (DHCF) and collects medical, dental, and pharmacy claims, eligibility files and …

Two papers published by The Source were cited in the latest Milbank Memorial Fund report “California’s Sutter Health Settlement: What States Can Learn About Protecting Residents from the Effects of Health Care Provider Consolidation”. The first, “Addressing Health Care Market Consolidation and High Prices”, is co-authored by The Source’s Jaime S. King and Katherine L. Gudiksen, with Robert A. Berenson et al. for the Urban Institute. The second paper is “Preventing Anticompetitive Healthcare Consolidation: Lessons From Five States”, written by Jaime S. King, Samuel M. Chang, et al. and jointly published …

As unrelenting consolidation in healthcare provider and insurer markets continues, policymakers need additional options to protect the public from escalating healthcare prices and low-quality care. High healthcare prices result from multiple factors, including third-party payers dampening consumers’ price sensitivity, patients and providers demanding expensive healthcare technologies, and healthcare markets consolidating. While these factors are visible, dominant insurers and healthcare providers can also use terms in their insurer-provider contracts in anticompetitive ways that thwart competition and lead to higher prices or lower quality but remain hidden from public view. With support …

The Source is launching a new series of “Spotlight on State” summaries to highlight notable legislation and initiatives in health policy and reform of all 50 states. Utilizing the SLIHCQ Database launched in partnership with Catalyst for Payment Reform, our goal is to update the overview summaries of each of the individual state pages on The Source, along with an exciting new feature of an overview infographic chart that provides an at-a-glance summary of existing and proposed legislation in each of the key issue topics for each state. The key …

See case page: UFCW & Employers Benefit Trust v. Sutter Health After much delay due to the pandemic induced hiatus, the preliminary approval hearing for the proposed settlement agreement in the Sutter Health antitrust case resumed on August 12 at the Superior Court of San Francisco. At the hearing, plaintiff attorneys on behalf of both class members UEBT and the Attorney General addressed in turn questions with respect to specific proposed terms raised in a tentative ruling by Judge Anne-Christine Massullo.[1] One key issue the court rested on was the selection …

See case page: UFCW & Employers Benefit Trust v. Sutter Health At a July 9 hearing at the Superior Court of San Francisco, Judge Anne-Christine Massullo denied Sutter Health’s motion to delay the approval hearing of the preliminary settlement agreement due to the COVID-19 pandemic. This is an encouraging ruling as there was much speculation and concern that Sutter’s request is a thinly veiled attempt to walk back the historic settlement reached last December amidst the chaos of COVID-19. In a California Healthline quote last month, The Source Executive Editor …

After much anticipation and a round of public comments on the draft guidelines released in January, the Department of Justice (DOJ), along with the Federal Trade Commission (FTC), officially issued the final Vertical Merger Review Guidelines, replacing the Non-Horizontal Merger Guidelines originally issued in 1984. The updated guidelines govern how federal antitrust agencies evaluate vertical, as well as other non-horizontal mergers. The guidelines outline three main sources of evidence for potential adverse competitive effects from vertical mergers: 1) Foreclosure and Raising Rivals’ Costs, 2) Access to Competitively Sensitive Information, and …

Case page: UFCW & Employers Benefit Trust v. Sutter Health Executive Editor Jaime King was quoted in the 6/17/2020 California Healthline article Citing COVID, Sutter Pushes To Revisit Landmark Antitrust Settlement: In its filing, Sutter does not specifically object to the $575 million settlement amount. But Jaime King, an associate dean at UC Hastings College of the Law who has followed the case, said the request for a delay could be a tactical strategy to support such a move. “The longer they can delay, the more they can show they have …

Tune in to the latest podcast with Anna Sinaiko, PhD, Assistant Professor at the Harvard T. H. Chan School of Public Health, who discusses with Catalyst for Payment Reform (CPR) Executive Director Suzanne Delbanco past price and quality transparency efforts and benefit design programs. CPR, in partnership with The Source, recently released a Report Card on State Transparency Laws that assesses state efforts to help consumers access health care price information to facilitate consumer shopping (see Suzanne Delbanco’s op-ed in Governing). This latest podcast from CPR provides insights on patient preferences in …

Recent evidence demonstrates that provider and insurer markets in the United States have been highly concentrated for years and have led to increased healthcare prices and insurance premiums without a commensurate increase in quality. The coronavirus pandemic is placing additional financial strain on many physician practices and small, rural hospitals, elevating the risk of unchecked consolidation. State governments can play a critical role in improving oversight of anticompetitive mergers and other affiliations, especially in this time. With support from Arnold Ventures and in collaboration with the Nicholas C. Petris Center on Health …