Happy New Year, Source Readers! We kick off 2023 with highlights of some reports and articles that you may have missed from December. In surprise billing protection efforts, the implementation of the No Surprises Act is hitting unexpected backlogs in the IDR process, while the loophole of ground ambulance surprise bills also warrants further policy attention. Reports on healthcare spending and out-of-pocket costs suggest that healthcare is becoming less affordable as out-of-pocket costs continued to rise. Lastly, a pair of studies on value-based payment models reveal flaws in the systems …

In the 2022 session, California enacted legislation to create the state’s healthcare cost commission, the Office of Healthcare Affordability (OHCA). As part of the Department of Health Care Access and Information (HCAI), OHCA is authorized to analyze the health care market for cost trends and drivers of spending and set and enforce cost-growth benchmarks for the state. It also has the authority to review and assess the impact of mergers, acquisitions, affiliations, and other healthcare transactions on price and competition. As OHCA prepares for its launch, the California Health Care Foundation …

As the end of the year approaches, there’s no better time to catch up and reflect upon new research and findings from the past year. The articles and reports in this month’s Roundup examine the latest trends in consolidation including (1) the rise of cross-market hospital systems and (2) concentration in the insurance markets. We also highlight articles that explored (3) the current state and future of telehealth regulation and (4) quality impact for hospitals that switch to a value based payment model.   Consolidation and Competition Although 2022 has …

The Source on Healthcare Price & Competition is thrilled to announce the launch of the newest interactive key issue pages in Provider Rate Regulation. Along with a report published in Frontiers in Health Services, this series of key issue pages aim to provide state policymakers with a roadmap of effective strategies to address rapidly increasing prices. In many markets, where existing competition are insufficient to constrain the pricing power of dominant insurers and providers, policymakers need to consider options to directly limit the unrelenting increase of healthcare prices that threatens the affordability of health care for Americans. With support …

Year two of California’s 2021-2022 legislative term came to an end last month as the Governor signed 997 bills into law and vetoed 169. The state considered healthcare bills that were rolled over from 2021 as well as new ones that were introduced in 2022. At the end of the 2021 session, The Source recapped noteworthy bills impacting healthcare price and competition that were enacted (see blog post). In the 2022 session, the legislature again made efforts to promote healthcare access and affordability in California through several legislative themes. In …

In this month’s Roundup, we highlight some noteworthy articles and reports that discuss 1) state options for provider rate regulation and their potential pitfalls such as regulatory failure and regulatory capture; 2) consolidation trends in the hospital market and pharmaceutical industry; 3) price transparency efforts including compliance with the hospital and insurer transparency rules and the state-federal partnership to implement the No Surprises Act; and 4) drivers of national health spending.   Provider Rate Regulation With the rapid consolidation of health care providers and highly concentrated insurance markets, consumer bargaining …

On October 27, The Source Executive Editor Katie Gudiksen will join a panel of experts for the Bipartisan Policy Center in a virtual event on “Taming Health Insurance Costs for Employers and Employees”. The panel is moderated by Health Affairs Editor-in-Chief Alan Weil and will discuss strategies to rein in health care costs and allow employers to provide high-value, cost-effective insurance to their employees. Be sure to register in advance here! October 27 | 1:00 – 2:00 p.m. ET | Virtual Participants: Marilyn Serafini (introduction), Executive Director, Health Program, BPC …

Fall is upon us, and the time is better than ever to sip on a cup of tea (or coffee) and catch up on some of the latest articles and reports! In this month’s Source Roundup, we cover a variety of topics in healthcare price and competition. First, we shine the spotlight on the rise in private equity acquisitions, particularly of physician practices and ambulatory surgical centers, and highlight some of the latest studies that examine the implications of these acquisitions on healthcare cost and spending, utilization, and quality. Second, …

In this month’s Source Roundup, we start out with the latest articles and reports that examine consolidation and lack of competition in the healthcare markets, specifically 1) the impact of certificate of public advantage legislation and 2) the impact of dialysis consolidation on Medicare Advantage beneficiaries. We also highlight a few articles discussing healthcare prices and costs, including 3) the impact of inflation on the healthcare sector, 4) the divergence in cost growth between Medicare and the private insurance sector, and 5) factors that cause health spending to rise in …

Summer may be going by like a breeze, but you can still catch up on some of the latest studies and reports in healthcare market and prices in the Source Roundup as usual. In this issue, we first take a look at the latest trends in hospital and health system consolidation. More than a year since the implementation of the federal hospital transparency rule, researchers continue to study and examine the hospital price data that were disclosed, including characteristics of hospitals that have complied with the rule, trends in prices …