THE SOURCE BLOG

Hot off the press: JAMA Health Forum article Promoting Health Care Transparency via State Legislative Efforts highlights state health transparency legislation from The State Laws Impacting Healthcare Cost (SLIHCQ) Database, a public database established by The Source on Healthcare Price and Competition and Catalyst for Payment Reform (CPR). The article looks at specific examples of state transparency legislation catalogued in the database including: All-payer claims database (APCD) – New Hampshire, Colorado Right-to-shop – Maine, Utah Surprise or balance billing – New York Find out details of these state legislation and …

We did it again! The Source on Healthcare Price & Competition is proud to announce that, in partnership with UC Berkeley’s Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, we have launched another brand new interactive key issue page, “Provider Contracts”, which looks at the most effective strategies for states to understand and address the ability of providers with dominant market power to utilize contracting strategies to negotiate high rates. With support from Arnold Ventures, this new installment is part of a collaborative research series that leverages the latest and most comprehensive data on state laws, healthcare markets, and healthcare prices in provider …

In this edition of the Source Roundup, we highlight articles and reports from February that discuss: (1) the prevalence of out-of-network billing during elective procedures with in-network services, (2) affordable care organizations’ potential to limit out-of-network spending, (3) findings from the new Health Care Cost and Utilization Report, (4) private health care spending growth  varies by hospital referral regions, (5) U.S. has highest healthcare spending despite worst health outcome, and (6) how states policies encourage provider market competition and lower healthcare spending.   The Prevalence of In-Network Care that Result …

SAN FRANCISCO, Calif. – February 25, 2020 – High commercial health care prices are a main driver of US health care spending, due in large part to consolidation among providers. While employers, other health care purchasers and payers can drive competition in the marketplace through benefit and provider network design, public policies can also strengthen and support those efforts. Catalyst for Payment Reform and The Source on Healthcare Price and Competition at UC Hastings College of the Law have catalogued state measures to enhance market competitiveness and control costs through legislation. The report, State Policies …

Early in January, the Department of Justice (DOJ), along with the Federal Trade Commission (FTC), released a new draft guideline for vertical merger review and sought public comments. On February 24, The Source Executor Editor Jaime King, along with health economists and policy experts including Source Advisory members Tim Greaney and Richard Scheffler, jointly released “Comments on the Draft Vertical Merger Guidelines with Special Consideration to Health Care”. The comments raise concerns and urge that special attention be paid to the effects of vertical mergers in the health care sector, …

The Source has been closely following legal challenges to state legislation that seek to promote competition and contain costs in healthcare services. In this month’s Litigation and Enforcement Highlights, we roundup the latest developments in some of the pending cases as well as new lawsuits that have been filed to derail state efforts to address rising prescription drug costs.   Arkansas: Supreme Court Grants Review of PBM Law In November 2019, the Source Blog covered the long litigious history of lawsuits filed against various pharmacy benefit manager (PBM) laws from …

For those of you who have followed the storied trajectory of the Affordable Care Act (ACA), affectionately called Obamacare, strap yourselves in because here we go again. After months of waiting for an opinion, on December 18, 2020, which incidentally was the day of Donald Trump’s impeachment, the 5th Circuit Court of Appeals issued its opinion in Texas v. U.S., the most recent challenge to the constitutionality of the ACA. The three-judge panel ruled two to one that the individual mandate was unconstitutional in the absence of a tax penalty, …

Happy February!  Here at The Source, we are grateful for the extra day in February to give our readers time to catch up with the latest health policy analysis and literature.  This edition of the Source Roundup looks at articles and reports on 1) how monopolies have hurt consumers and what states can do to combat hospital acquisitions and mergers, 2) how well states are doing to make health care affordable; 3) why a single-payer system is financially feasible; and 4) what the United States can learn from other countries’ …

In California and elsewhere, the closure of emergency departments (“ED”) reduces access and negatively affects patient health, particularly to the primary users of EDs, who are often low-income and most affected by the closure. In 2014, the American College of Emergency Physicians (ACEP) observed that California had the lowest number of EDs per capita[1] and gave California an “F”, ranking the state 42nd in the country in terms of access to emergency care.[2] However, California’s latest attempt to strengthen state oversight over ED closures faltered when Governor Newsom vetoed AB …

See UFCW & Employers Benefit Trust v. Sutter Health case page.   The high-profile antitrust case against Sutter Health settled on the eve of trial in October 2019, when the Northern California hospital giant reached a preliminary settlement agreement with the California Attorney General’s office and class action plaintiffs after five years of litigation. The terms of the settlement were released late December, which include both monetary compensation for the private plaintiffs and injunctions against Sutter’s conduct that will restore competition and promote transparency in the provider market. In this …