Provider Payment
The Source Roundup: November 2018 Edition
Source Fellow November 1, 2018
By: Swaja Khanna, Student Fellow Happy November! We hope you are enjoying football season and preparing for turkey! In this edition of the Source Roundup, we cover five academic articles and reports from October. The topics this month include (1) the popularity of telemedicine for employers and employees, (2) an integrated health care system that combines ACO and bundled payment, (3) health spending growth in the coming years, (4) Maryland’s new initiative reduced hospital utilization and costs, and (5) how to remedy recent generic drug price hikes. Telemedicine Is …
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The Source Roundup: August 2018 Edition
Tiffany Wang, Student Fellow August 1, 2018
Happy August! In this edition of the Source Roundup, we cover four academic articles and reports from June and July. The topics this month include: (1) price transparency as a means to affordable health care; (2) effect of state-based individual mandates; (3) Trump’s 5-Part Medicare Part D plan; and (4) Medicare’s experiment with bundled payments. Price Transparency Goals to Achieve Affordable Health Care Skeptics have questioned whether consumer price transparency initiatives are an effective means of driving down healthcare costs. In the NEJM Catalyst article, “Defining the Goals of …
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The Source Roundup: June 2018 Edition
Source Fellow June 1, 2018
By: Megan O’Leary, Student Fellow Happy June! In this edition of the Source Roundup, we cover five academic articles and reports from April and May. The topics this month include: 1) barriers for generics to lower specialty drug prices, 2) a call to reform pharmaceutical systems in the United States and Canada, 3) efforts by states to stabilize the individual market, 4) Vermont’s push for community-driven health care reform, and 5) antitrust lawsuits in the pharmaceutical industry. Barriers for Generics to Lower Specialty Drug Prices The Health Affairs article Generic …
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Special California Assembly Hearings Provide Insights and Solutions to Increasing Healthcare Costs
Sammy Chang, Health Policy Researcher February 20, 2018
After the public outcry following last year’s tabling of SB 562 (Lara), which would have created a single-payer program in California, a special California Assembly committee was formed. The Assembly Select Committee on Health Care Delivery Systems and Universal Coverage began hearings in late October 2017 and adjourned on February 7th, 2018. While much of the hearings was a crash course on health insurance, some of them addressed high healthcare prices. This month, we will summarize two of the hearings that focused on understanding the origins of high healthcare pricing …
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The Source Roundup – January 2018 Edition
Source Fellow January 2, 2018
By: Briana Moller, Student Fellow Happy New Year! In this Roundup, we cover four articles from November and December 2017. The topics include 1) the rising cost of emergency care, 2) promoting price transparency through contract law, 3) the move towards value-based payment systems, and 4) government regulation to control prescription drug prices. Rising Cost of Emergency Care As a part of a year-long investigation, Vox, working alongside the Health Care Cost Institute (“HCCI”), investigated the recent phenomenon of increased emergency room prices. In “Emergency Rooms Are Monopolies. Patients …
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Do Bundled Payments Have a Future in Medicare?
Katie Gudiksen, Senior Health Policy Researcher December 7, 2017
In an op-ed written for the Wall Street Journal on September 19, 2017, Seema Verma, the new administrator for the Centers for Medicare &|Medicaid Services (CMS), announced a “new direction” initiative for the Center for Medicare and Medicaid Innovation (CMMI).[1] The Affordable Care Act (ACA) created the CMMI to design and evaluate new payment models designed to either lower spending without reducing the quality of care, or improve the quality of care without increasing spending.[2] The CMMI established payment initiatives that used Medicare to test and implement payment reforms that …
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Source Shorts: Medicare Officially Kills Program to Pilot Pharmaceutical Payment Reform
Katie Gudiksen, Senior Health Policy Researcher October 4, 2017
The Centers for Medicaid and Medicare officially dropped any attempt to implement a pilot program that would change the way drugs were reimbursed under Medicare Part B. This pilot reform attempt has been on hold for more than a year, but CMS has now officially withdrawn it. How does Medicare Part B cover prescriptions? Medicare Part B only covers drugs that are administered in a doctor’s office or clinic, which are primarily intravenous and injectable drugs (the bulk of pharmaceuticals are covered under Medicare Part D and would not …
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Academic Articles & Reports Roundup: October 2016
Anna Zaret, Managing Editor November 1, 2016
We hope you had a happy Halloween! October’s roundup includes articles covering 1) price transparency|2) provider collaborations in California|3) antitrust doctrine on state immunity|4) payment reforms|and 5) consumer healthcare costs. For the next few months, we will be using the Roundup to focus on a few great healthcare price and competition articles, rather than reporting on a wider array of articles that came out in the month. If you think we have overlooked any interesting articles, please feel free to send us what we’ve missed! Price Transparency In The New …
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Academic Articles & Reports Round Up: June 2016
Anne Marie Helm, Managing Editor July 1, 2016
June’s articles ran the gamut of the Source’s favorite topics: price transparency, new payment models, provider markets and pricing, state strategies, and reforming the entire U.S. healthcare system. PRICE TRANSPARENCY The Society of Medical Decision Making published an interesting study on how consumers respond to healthcare pricing information, Presenting Comparative Cost Information to Consumers: Easier Said Than Done by Jessica Greene, PhD and Rebecca M. Sacks, MPH. Participants in the study were provided online cost and quality information in various forms, and then asked to select a provider. Not surprisingly, …
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Academic Articles & Reports Round Up: March 2016
Elizabeth Nicholson, Research Fellow April 1, 2016
Happy Spring! A common theme among the healthcare articles and reports, published in March, was payment reimbursement systems (fee-for-service versus value-based systems) and Accountable Care Organizations (“ACOs”). In addition, typical healthcare topics were also reported on. These include healthcare cost|insurance cost|healthcare competition|and suggested improvements for the United States healthcare system. As a bonus, a few articles and reports focused on healthcare cost and competition issues in other countries. FEE-FOR-SERVICE REIMBURSEMENT MODEL Health Affairs posted an article entitled Fee-For-Service, While Much Maligned, Remains the Dominant Payment Method for Physician Visits. The article’s …
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