Cost Containment
The Source Roundup: July 2021 Edition
Michele Ellson, Student Fellow July 1, 2021
This month, we are proud to announce the publication of an issue brief by our Source colleagues Katherine L. Gudiksen, Alexandra D. Montague, and Jamie S. King on the topic of healthcare market consolidation—and more specifically, on what state and federal leaders are doing to deal with it. This month’s Roundup also discusses new research about a potential link between ACO participation and higher prices, hospitals’ lagging price transparency compliance efforts, surprise ambulance bills, the future of telehealth, enrollee satisfaction with public and private health plans, and state employee health …
Continue Reading Download PDF
The Source Roundup: June 2021 Edition
Michele Ellson, Student Fellow June 1, 2021
The election of Joe Biden to the presidency could mean expanded access to healthcare coverage and increased government regulation of anticompetitive mergers and other practices. Already, Biden and Congress have increased access by temporarily expanding eligibility for health plan premium tax credits. Are other changes on the horizon? This month’s Roundup covers research on 1) the potential fiscal impacts of expanding eligibility for Medicare, 2) the views of a key stakeholder in conversations about expanding government’s role in providing care and regulating competition, 3) the potential savings that could be …
Continue Reading Download PDF
The Source Roundup: May 2021 Edition
Erin Livinghouse, Student Fellow May 3, 2021
This month’s roundup covers academic articles and reports that examined: 1) early results and challenges of the new federal price transparency rule; 2) how to address increasing market consolidation and competition during the COVID-19 pandemic; 3) rising healthcare costs; and 4) how much patients pay and physicians receive when patients receive out-of-network emergency care. Price Transparency In response to policymakers calling for greater price transparency of healthcare services for patients and other payers of healthcare, a federal rule from the Department of Health and Human Services took effect on …
Continue Reading Download PDF
The Lower Health Care Costs Act: A Bipartisan Federal Effort to Improve Competition in Healthcare Markets
Katie Gudiksen, Senior Health Policy Researcher June 21, 2019
The Lower Health Care Costs Act, released in May 2019 by Senators Lamar Alexander and Patty Murray, addresses many inefficiencies in healthcare markets and has the potential to both increase competition and lower costs for healthcare services. The 195-page draft federal bill, also known as the Alexander-Murray Bill (S 1895), contains more than three dozen provisions designed to address health care costs. The bill is divided into five titles: 1) Ending Surprise Medical Bills, 2) Reducing the Prices of Prescription Drugs, 3) Improving Transparency in Health Care, 4) Improving Public …
Continue Reading Download PDF
The Source Roundup: May 2019 Edition
Tiffany Wang, Student Fellow May 1, 2019
Happy May! We hope you’re enjoying the longer, sunnier days of spring. In this edition of The Source Roundup, we survey articles and reports that discuss 1) health system consolidation’s impact on healthcare prices and quality, 2) the new federal price transparency rule, and 3) cost-containment strategies from various fronts. More Evidence of Hospital Market Concentration’s Negative Impact on Competition and Healthcare Costs Two articles this month reinforced the principle that protecting access to affordable healthcare requires strong antitrust enforcement policies to ensure adequate competition among hospitals and hospital systems. …
Continue Reading Download PDF
Better Data for Better Results: AB 1122’s Super User Pilot Project and Other 2019 Bills That Improve Health Care Transparency
Sammy Chang, Health Policy Researcher April 30, 2019
As California continues its implementation of an all-payer claims database, we take a look at other bills the Legislature introduced to further the aim of better understanding the factors and activities that drive health care costs and quality. SB 343 subjects the Kaiser Permanente system to the same reporting requirements as other plans and hospitals. SB 612 and AB 929 mandate public disclosure of cost reduction and quality improvement activities. Additionally, AB 1122 proposes a pilot project that utilizes existing data sets to identify a new data set: high health …
Continue Reading Download PDF
The Source Roundup: April 2019 Edition
Source Fellow April 1, 2019
By: Erin Sclar, Student Fellow Spring is finally here! With it, we review articles and reports about 1) single payer health plans and universal health care, 2) the causes, effects, and possible solutions to rising prescription drug pricing, and 3) health care costs and price transparency. Single Payer Health Plans and Universal Health Care The terms “single payer health plans” and “universal health care” are becoming increasingly familiar as the 2020 elections approach. But the meanings of these terms, and the specific policies and proposals associated with them, are often …
Continue Reading Download PDF
The Source Roundup: March 2019 Edition
Source Fellow March 1, 2019
By: Leah S. Gray, Student Fellow Happy March! This month we take a look at articles that examine 1) state health system reform efforts, 2) protections against surprise medical bills, 3) effects of market concentration on cost and quality, and 4) ways to control rising costs for health care and pharmaceuticals. States are taking the lead in health system reform While the federal health policy debate has remained rather stagnant, states have stepped up protect their citizens from rising health care costs. North Carolina is poised to make rapid, unprecedented …
Continue Reading Download PDF
The Issues with Prior Authorization and Why Reform Is Needed
Source Fellow February 25, 2019
By: Swaja Khanna, Student Fellow Late last year, in the middle of the holiday season, I needed a prescription medication urgently. My physician prescribed it on December 13th. I received the medication on December 20th. It took a whole week to get a medication that I should have long finished by the time I actually received it. I was deeply frustrated not only because I was physically ill, but also because I was dealing with a great deal of uncertainty. When I attempted to pick up my medication from the …
Continue Reading Download PDF
Recapping the 2017-2018 California Legislative Session (Part 2): Incremental Steps Made in Scrutinizing Market Changes and High Health Care Costs
Sammy Chang, Health Policy Researcher January 29, 2019
As California begins its 2019-2020 legislative cycle, we look back at the 2017-2018 bills that will affect California health care costs and markets. Previously, we mentioned that last session’s health care bills coalesced around four themes: targeting high costs of prescription drugs, attempting to implement single payer, regulating competition, and limiting high health costs. In Part 1 of our review, we covered how the legislature banned pharmacy gag clauses and limited out of pocket expenses but failed to implement single payer. This time, we’ll look at 2017-2018 bills that sought …
Continue Reading Download PDF