Healthcare System Mergers and Investment Models for Enhanced Health Care Market Oversight – State Attorneys General, Health Departments, and Independent Oversight Entities (Milbank Memorial Fund) Erin C. Fuse Brown, Katherine L. Gudiksen The Source’s own Katherine L. Gudiksen co-authored this report for the Milbank Memorial Fund with Eric C. Fuse Brown, which assesses the tools state policy makers are using to address harmful health care market consolidation. Specifically, the report focuses on how states have broadened review authority by expanding the existing authority of the Attorney General (or other state …

This month’s roundup of studies and reports highlights growing consolidation in health care as well as increasing costs of care. One report predicts higher medical costs in 2024—a trend that continued from the last two years. Another report highlights that policy efforts to reduce facility fees charged by hospitals are a potential avenue for controlling costs. Global capitation, in particular one value-based model utilized in Maryland, may help reduce the cost of specialty care delivery. Meanwhile, trends in the size of physician practices and recent M&A activity are indicators of …

California’s Medi-Cal program is the largest Medicaid program in the country. It is tasked with providing care for approximately 15 million enrollees, or one third of California’s population. To ensure affordability while maintaining quality and improving health care outcomes, CalAIM was created as California’s newest approach to reform Medi-Cal, including changes to managed care plans and reimbursement of behavioral health plans. Although many of these objectives under CalAIM are still in the initial implementation stages, the potential ramifications of this multi-year, billion-dollar investment in changing how millions of people receive …

Updated: February 6, 2023 On Friday, February 3, Source Executive Editor Katie Gudiksen will speak at the Connecticut & U.S. Healthcare Cost Drivers Informational Session II regarding rate review and global budgets. This is an all-day event jointly hosted by the Connecticut Insurance Department, Office of Health Strategy, and Office of the Healthcare Advocate (OHA). It will be broadcast live on the Connecticut CTNetworkTV @9AM – 3PM EST on https://ct-n.com/ and recorded for future viewing. Updated 2/6: Recording is now available here. Katie’s presentation “Roadmap to Constrain Commercial Health Care …

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 …

Happy Summer! We kick off the holiday weekend with the latest research and articles in healthcare price and competition. This month’s Roundup highlights articles and reports that discuss 1) the impact and trends of private equity investment in health care; 2) compliance trends of the federal Hospital Price Transparency Rule; and 3) the role of high prices in excess healthcare spending in the U.S. and possible strategies for cost containment, including methods to limit costs and spending, such as 4) health savings accounts, 5) out-of-pocket spending limit for Medicare, and …

This month, we are pleased to highlight new publications co-authored by The Source-affiliated health policy researchers and scholars, discussing 1) the potential benefits of all-payer hospital global budgets, and 2) the legal viability and policy effects of state public option health plans. Additionally, we examine articles covering research on 3) hospital service offerings based on ownership type, 4) the correlation between hospital prices and patient outcomes, 5) data sources within California’s physician practice landscape, and 6) the labor market impact of hospital mergers.   Healthcare Reform and Cost Containment High …

By: Hayden Soria, Student Fellow Happy August! Even as the summer winds down, there is no waning of health policy literature. In this month’s Source Roundup, we take a look at academic articles and studies that analyze 1) potential prescription drug savings from generics and biosimilars, 2) the need for price transparency, and 4) a multitude of efforts in health system reform.   Potential Prescription Drug Savings from Generics and Biosimilars As prescription drug pricing continue to capture the nation’s attention, Stacie B. Dusetzina et al. take a dive into cost …

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] From 2013 to 2016, Medicaid’s nationwide drug spending increased almost 50%, from $22.4 billion to $33.4 billion.[2] Medicaid programs consume an increasing percentage of state budgets and threaten to overtake funding for other programs like education and infrastructure.[3] In 2018, the National Association of State Budget Officers (NASBO) estimated that Medicaid accounted for nearly 30% of total state spending and is the fastest growing component of …