Reference Pricing
A Breakdown of CHA’s Case Against OHCA’s Hospital Spending Targets
Bruce Allain, Managing Editor November 17, 2025
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 […]
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Vermont Enacts Significant Legislation Addressing Healthcare Costs and Hospital Budgets
Anna Chau August 8, 2025
On June 12th, 2025, Vermont Governor Phil Scott signed S0126 into law, in which the state aims to improve quality of care and healthcare access by stabilizing healthcare costs through Medicare-based price regulation, creating global hospital budgets, and establishing a more stable and high-quality state healthcare network. The new law intends to do so through controlling costs for commercial insurance, managing hospital costs by using price caps, and overseeing and assessing administrative processes. The law tasks the Green Mountain Care Board (GMCB) with accomplishing these objectives. Vermont’s current system for […]
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The Source Roundup: July 2025 Edition
Megan Bochum July 1, 2025
Healthcare Cost Control State Health Care Cost Commissions: Their Priorities and How States’ Political Leanings, Commercial Hospital Prices, and Medicaid Spending Predict Their Establishment (The Milbank Quarterly) Brent D. Fulton, Daniel R. Arnold, Jordan M. Wolf, Richard M. Scheffler As healthcare costs continue to rise, states play an increasingly important role in addressing affordability and cost containment. In this Milbank Quarterly article, researchers examine the political and economic measures in the 17 states that have created Health Care Cost Commissions (HCCCs). HCCCs are independent administrative bodies usually housed in the […]
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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 […]
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The Source Roundup: October 2018 Edition
Source Fellow October 1, 2018
By: Jake Winton, Student Fellow Welcome to October! We hope you are getting your costumes picked out and finding those deals to stock up on trick-or-treat candy. In this edition of The Source Roundup, we review five academic articles and reports from September that stood out to us. This month we look at (1) price inflation in the California fully-insured large group market, (2) forward motion in drug price transparency laws, (3) the future of pharmaceutical reference pricing in the U.S., (4) lessons learned from California’s competitive healthcare model, and (5) […]
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Reference Pricing: When Transparency Is Not Enough
Katie Gudiksen, Senior Health Policy Researcher June 12, 2018
In most markets, consumers can compare prices and shop for the items they want. For example, to buy a new pair of shoes, a consumer can typically drive to a shopping mall and choose from a number of stores. Each store typically carries a number of different styles and brands. The consumer might choose to pay $500 for a designer pair of heels or $25 for an inexpensive pair of tennis shoes. The consumer can also shop online and have the shoes shipped to his or her home. Regardless of […]
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The Source Roundup: May 2018 Edition
Amy Y. Gu, Managing Editor May 1, 2018
Happy May! In this edition of the Source Roundup, we cover four academic articles and reports from March and April. The topics this month include: 1) the unfilled promise of price transparency to encourage price shopping, 2) FDA’s actions on prescription drug prices, 3) the phenomenon of overpayment for prescription drugs, and 4) results of Maryland’s All-Payer global hospital budgeting program. Unfulfilled Promise of Price Transparency to Encourage Price ShoppingIn Promise and Reality of Price Transparency, a health policy report published by the New England Journal of Medicine, authors Ateev Mehrotra, Michael […]
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The Source Roundup: April 2018 Edition
Source Fellow April 2, 2018
By: Briana Moller, Student Fellow Happy April! In this edition of the Source Roundup, we cover five academic articles from February and March. The topics this month include: 1) a comparative look at US health care spending and 2) solutions to the rising cost of prescription drugs. Comparative Look at US Health Care Spending In the JAMA article, “Health Care Spending in the United States and Other High-Income Countries,” authors Irene Papanicolas, Liana R. Woskie, and Ashish K. Jha compare health care spending in the United States with other […]
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Academic Articles & Reports Roundup: August 2017
Sammy Chang, Health Policy Researcher September 1, 2017
Happy September! In this Roundup, we cover four articles from July and August. The topics this month include (1) how states could use the excise tax to discourage forum shopping by insurance plans, (2) the effect of reference pricing on consumers’ drug selection, (3) proposals to promote the use of cost-effective technology in insurance, and (4) possible barriers that prevent consumers from seeking out price information. How States Could Use the Excise Tax to Discourage Forum Shopping by Insurance Plans In How States Can Respond to the AHCA: Using […]
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Academic Articles and Reports Roundup: March 2017
Anna Zaret, Managing Editor April 2, 2017
Happy April! We hope you are enjoying the start of longer and warmer days. This month’s roundup includes articles from March about 1) the impact of reference pricing|2) policies to promote healthcare market competition|3) chargemaster list prices|and 4) ACA enrollment figures. 1) The Impact of Reference Pricing Reference Pricing Changes the ‘Choice Architecture’ Of Health Care For Consumers published by James C. Robinson, Timothy T. Brown, and Christopher Whaley (Health Affairs), discusses how reference pricing has impacted provider prices, patient choices, quality of care, and employer expenditures. The authors […]
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