Source Insights
Rate Setting for Health Services: A “Radical” Proposal or A Proven Way to Control Healthcare Costs?
Katie Gudiksen, Senior Health Policy Researcher April 27, 2018
On February 16, 2018, California State Assembly Member Ash Kalra introduced Assembly Bill 3087 – The Health Care Price Relief Act, which calls for a commission to set uniform rates for medical providers, including hospitals and physicians, for the private-insurance market. The bill sets the floor for payment at the Medicare rate and places the onus on providers to apply for adjustments to the base amount.[1] AB 3087 advanced out of committee on April 25, 2018, but faces fierce opposition from doctors and hospitals, among other groups.[2] In this post, The Source …
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Are APCDs the Solution to Price Transparency in Healthcare?
Katie Gudiksen, Senior Health Policy Researcher April 16, 2018
As health care costs continue to rise, voters have identified “health care” as the top issue for the 2018 elections. In response, in March 2018, a group of bipartisan Senators asked thirty stakeholders for feedback as they develop legislation to increase price transparency in the healthcare market in order to increase competition and drive down prices for healthcare services. A lack of price transparency for health care prevents patients from shopping for medical care the way they can for other services, thereby driving up costs. There are no consistent or …
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Single-Payer vs. Public Option: Can Either System Address Rising Health Care Prices?
Katie Gudiksen, Senior Health Policy Researcher March 29, 2018
In February 2018, the Centers for Medicare and Medicaid Services (CMS) released data that National Health Expenditures accounted for 17.9% of Gross Domestic Product (GPD) and exceeded $10,300 per person. Even more alarming, CMS predicts that health expenditures will increase at an average rate of 5.5%, faster than inflation or increase in GPD, so that by 2026, health care will cost almost 20% of GDP. As a result of escalating costs of health care and increasing cost-sharing and co-pays for individual patients, those on the left of the political spectrum …
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Medicaid Work Requirements Place a Burden on Access to Health Care
Source Fellow March 10, 2018
By: Briana Moller, Student Fellow Many states are now moving to impose work requirements for Medicaid benefits, a process that has been in the works for quite some time under the Trump administration. Currently, two states have been approved to impose work requirements and several other states have applications pending. Here are some of the key events leading up to this point: On March 14, 2017, Seema Verma, the Administrator of the Center for Medicare and Medicaid Services, (“CMS”) and Tom Price, the former Health and Human Services (“HHS”) Secretary …
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Could the Amazon, Berkshire, JP Morgan Chase Venture Disrupt the Healthcare Industry and Improve Employer Sponsored Insurance Competition?
Source Fellow March 6, 2018
By: Katie Beyer, Student Fellow On January 30, 2018, Amazon, Berkshire Hathaway, and JP Morgan Chase announced their initiative to create a new company designed to lower healthcare costs.[1] Together, the three companies currently employ 1.1 million employees worldwide. On average, employers pay $5,179 annually (83 percent of the premium) to cover a single employee or $12,591 annually (72 percent of the premium) to cover a family.[2] Employees cover the remaining amount, typically through a payroll deduction. With a large combined employee base of 1.1 million, these companies spend billions of …
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A Drug Rebate’s Tale: How a Class Action Lawsuit in the 90s Shaped Drug Pricing
Katie Gudiksen, Senior Health Policy Researcher February 24, 2018
Do you ever wonder why it is so hard to know what a prescription drug actually costs? How did we get a system where prices are obscured, even from insurers, and contracts prevent pharmacists from telling patients when they are paying more than they should be? How did the pharmaceutical industry wind up in a world of rebates and complicated contracts with pharmacy benefit managers that result in a lack of transparency for everyone? Setting the Stage: The Lawsuits that Laid the Groundwork To understand how we got …
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How the Expansion of Association Health Plans Undermines the Safeguards of the ACA
Source Fellow January 29, 2018
By: Briana Moller, Student Fellow On October 12, 2017, President Donald Trump issued an executive order entitled “Promoting Healthcare Choice and Competition Across the United States.” This order states that the Administration will focus on changing, among others areas, the regulations surrounding association health plans (AHPs). This blog post explores the expansion of association health plans and its consequences. Department of Labor’s Proposed New Rule The executive order specifically called upon the Department of Labor to allow more employers to participate in AHPs. As a result, on January 4, 2018, …
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Do Drugs That Treat the Same Indication Compete with Each Other?
Katie Gudiksen, Senior Health Policy Researcher January 23, 2018
High drug prices and the rate at which they are increasing worry most Americans. A quarter of Americans report difficulties affording their medications. Recognizing the need to control spending on prescription drugs, the Federal Trade Commission (FTC) held a workshop on November 8, 2017 entitled “Understanding Competition in Prescription Drug Markets: Entry and Supply Chain Dynamics.” At the workshop, Acting FTC Chairman Maureen K. Ohlhausen asserted that “competition is key to containing prescription drug costs”[1] and Commissioner of the Food and Drug Administration (FDA) Dr. Scott Gottlieb said that …
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How the 2017 Tax Reform Act May Impact Healthcare Costs and Spending
Source Fellow January 11, 2018
By: Katie Beyer, Student Fellow The 2017 Tax Reform Act, formerly known as H.R.1 the Tax Cuts and Jobs Act, was signed into law by President Trump on December 22, 2017. This politically charged bill first passed the Senate by a strict party line vote of 51-48 and passed the House by a final vote of 224-201. No Democrats voted for the bill in either the Senate or the House. Republicans were eager to pass the bill, claiming that families would see an average of $2,200 cut from their annual taxes.[1] …
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Crossing the Political Divide: Senate HELP Committee Hearings on Drug Prices
Katie Gudiksen, Senior Health Policy Researcher December 22, 2017
On December 12, 2017, the Senate Committee on Health, Education, Labor, and Pensions (HELP) held a bipartisan hearing on the cost of prescription drugs. This hearing was the third in a series of Senate HELP committee meetings on drug prices and was held in response to the release of the National Academies of Science, Engineering, and Medicine’s report entitled “Making Medicines Affordable: A National Imperative”. At the hearing, Senator Murray (D-WA), ranking member of the Senate Health Committee, noted that the price of prescription drugs was one of the …
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