HEALTHCARE COSTS
California Legislative Beat: Noteworthy 2017 Bills Still Pending That Should be Passed
Sammy Chang, Health Policy Researcher May 24, 2018
As year two of the California legislative session goes into full swing, a couple of bills introduced in 2017 are still active and waiting to be passed. This month’s post will look at four active 2017 bills that should be considered for passage. SB 199: This bill authorizes the creation of an advisory committee to research and develop recommendations on the creation of a database to be titled California Health Care Cost, Quality, and Equity Atlas. This bill is the first step to creating a statewide database that would collect …
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Litigation and Enforcement Highlights – May 2018
Amy Y. Gu, Managing Editor May 15, 2018
Several major court decisions were handed down last month that may leave lasting impacts in terms of price and competition in the healthcare industry. Specifically, the 4thCircuit Court of Appeals ruled Maryland’s Price Gouging Law unconstitutional, while the Supreme Court upheld inter partes review, a controversial patent review process. In antitrust enforcement, the Justice Department began its review of the Cigna-Express Scripts merger. 4thCircuit Strikes Down Maryland Price Gouging Law In a significant victory for the pharmaceutical industry, the 4thU.S. Circuit Court of Appeals found Maryland’s landmark 2017 law, …
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State Medicaid Programs are a Tool to Address Rising Drug Costs
Katie Gudiksen, Senior Health Policy Researcher May 8, 2018
Rising prescription drug prices concern nearly all Americans, with 80% reporting that drug prices are “unreasonable”. The problem of rising drug expenditures is particularly acute for state Medicaid programs, which provide health coverage for low-income and disabled Americans. Medicaid serves nearly one in five Americans including many with chronic conditions, and purchases about 10% of total prescription medications dispensed in the U.S.[1] Furthermore, Medicaid’s nationwide drug spending increased almost 50% between 2013 and 2016 (from $22.4 billion to $33.4 billion).[2] In a survey of Medicaid programs, 36 states reported increased cost containment efforts for prescription drugs …
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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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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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California Proposes Legislation to Establish An All-Payer Claims Database – 5 Questions and Answers to Understand AB 2502
Sammy Chang, Health Policy Researcher April 19, 2018
What is AB 2502 About?To better understand healthcare costs and promote price transparency, AB 2502 proposes the establishment of an all-payer claims database (APCD) in California. In general, all-payer claims databases collect health insurance claims from all payers, which inform policymakers on how to better control healthcare costs. The bill’s intent is to understand “how to reduce health care costs while improving quality and reducing disparities”, and to encourage “health care service plans, health insurers, and providers to develop innovative approaches, services, and programs that may have the potential to deliver health …
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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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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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California Legislature Turns Focus on High Drug Pricing
Sammy Chang, Health Policy Researcher March 21, 2018
Last month, we reviewed how the California Assembly is trying to understand cost drivers of healthcare overall. As California has the highest retail drug spending with prescription drug expenditures outpacing overall healthcare spending, high drug pricing has become a specific concern for the Legislature.[1] For the past few years, the Legislature has used bills[2] (like SB 17 (2017)), resolutions (like SJR 29 (2015)), and informational hearings to better understand and control high drug pricing. For example, the Assembly Health Committee (“Committee”) began a series of hearings to understand prescription drug …
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States’ Rights: A Patent Law Analysis of NASHP Rate Setting Model Act
Amy Y. Gu, Managing Editor March 15, 2018
The Source recently contributed to a white paper published by the National Academy for State Health Policy (NASHP) that weighs in on whether state drug rate-setting legislation violates patent law. The Source’s Managing Editor Amy Y. Gu and Senior Research Fellow Katie Gudiksen, along with a team of legal experts at the Institute for Innovation Law at the University of California Hastings College of the Law, explored in States’ Rights: A Patent Law Analysis of NASHP Rate Setting Model Act what states can do to address the rising cost of …
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