Healthcare Costs Growth In National Health Expenditures: It’s Not The Prices, Stupid Health Affairs Michael Chernew The article seeks to identify the causes of rising healthcare costs by assessing trends across sectors, including coding intensity, AI medical services, product costs, and healthcare consolidation and administrative shifts. Chernew reports that coding intensity has increased and explores the possible relationship to AI medical services, though notes it may be too early to identify any trends. Broad healthcare infrastructure changes show conflicting trends in prices, and the author advocates for more focus on […]

On January 9, California Governor Newsom released his first proposed budget for California’s 2026-2027 fiscal year, outlining $348.9 billion in state spending, $30 billion more than the current 2025-2026 budget.  California is facing challenges as federal funding for key programs has diminished under President Trump’s One Big Beautiful Bill.  Additionally, the budget is based on projected state revenues, which are difficult to determine given differing economic forecasts. Trump’s One Big Beautiful Bill reduces federal funding for California’s Medicaid program by $30 billion a year and makes significant cuts to food […]

Discussions of health care consolidation often center on providers and insurers, but growing concentration among the companies that operate behind the scenes poses equally serious risks.  For example, the Change Healthcare data breach in early 2024 caused significant disruptions in healthcare because Change processes approximately half of all U.S. medical claims, and a single cyberattack disrupted large swaths of the health care system.  Similar dynamics are playing out in other sectors of the health care system.  More than 305 million patients have electronic health records controlled by Epic.  At the […]

Antitrust Enforcement Fixing a Broken System: Policy Responses to Hospital Acquisitions of Physician Practices That Limit Health Care Access for U.S. Consumers Progressive Policy Institute Diana Moss, Alix Ware, Lief Lin By 2023, more than half of all independent physician practices (IPPs) were no longer independent, but owned by hospitals, health systems, or corporate entities, meaning 78% of all U.S. physicians were employed by large provider organizations. Loss of IPPs through vertical consolidation leads to higher prices, reduced access, loss of physician autonomy, and reduced patient choice. This study highlights […]

On November 9, the Indiana Department of Health issued a Certificate of Public Advantage (COPA) to allow Union Hospital to acquire Terre Haute Regional Hospital. The proposed merger would effectively combine the two only acute care hospitals in Vigo County and create a near‐monopoly for inpatient hospital services in the Terre Haute, Indiana area. The proposed acquisition drew opposition from the Federal Trade Commission (FTC) (under both the Biden and Trump administrations) and the state’s own Attorney General (AG). The COPA prevents state enforcement to challenge the merger as an […]

Several states passed legislation on key healthcare issues in the 2025 legislative session, including new laws addressing noncompete clauses, prior authorization, and price and ownership transparency. This article highlights five states that have passed significant legislation on healthcare pricing and competition in 2025. Indiana, Washington, Oregon, Montana, and Arkansas have all had ambitious sessions this year regarding healthcare reform; below, we highlight some of the key bills recently passed by these states. Indiana Indiana had an ambitious year in 2025, enacting several significant pieces of healthcare legislation. Having new laws […]

Healthcare Prices and Payments UnitedHealthcare Pays Optum Providers More Than Non-Optum Providers Health Affairs Daniel R. Arnold, Brent D. Fulton Optum has a history of increasing market power through aggressive acquisitions of healthcare services and has been accused of using that market power to impede provider competition for financial gain.  UnitedHealthcare and Optum are parts of the same company, with UnitedHealthcare serving as the insurance arm, and Optum providing healthcare services.  In 2024, Optum, which includes a variety of smaller entities such as a pharmacy benefit manager (PBM) and software […]

The Federal Push for Transparency Since the Affordable Care Act (ACA) was enacted in 2010, there has been a push for comprehensive healthcare reform, including early efforts to create price transparency. The ACA requires health plans to provide a summary of benefits and coverage, along with a list of definitions to facilitate consumer comprehension. In 2019, President Trump issued Executive Order (EO) 13877, which directed federal agencies to give patients access to real prices rather than estimates and to make pricing information comparable across health plans. Following that Executive Order, […]

This post is part of our ongoing coverage of the CHA v. OHCA lawsuit. See case page here. In this post, we examine the claims made by the California Hospital Association (CHA) in its recent lawsuit filed against the California Office of Health Care Affordability (OHCA) regarding OHCA’s plan to implement spending targets for hospitals (Case #  CPF25519370).  While many stakeholders, including CHA, the California Medical Association (CMA), and others, have expressed concerns about the spending targets announced by OHCA and the methodology used to establish them, dissatisfaction with an administrative […]

The Source’s executive editor Katie Gudiksen, working with Arnold Analytics, co-authored a report on hospital market competition in Monterey County. The report was released today by California’s Office of Health Care Affordability (OHCA). The study examines why prices at CHOMP, Natividad, and Salinas Valley Memorial are among the highest in the state and finds that limited competition—not higher costs or better quality—is the main driver. It also outlines the impact on local families and employers and offers policy options for the state to consider. Read the full report here: https://hcai.ca.gov/wp-content/uploads/2025/11/OHCA-Investigative-Study-of-Hospital-Market-Competition-in-Monterey-County.pdf.