Effects of Market Consolidation Cost, Quality, and Utilization After Hospital-Physician and Hospital-Post Acute Care Vertical Integration: A Systematic Review (Medical Care Research and Review) Alexandra Harris, Sarah Philbin, Brady Post, Neil Jordan, Molly Beestrum, Richard Epstein, Megan McHugh To determine the impact of vertical integration, the authors examine the associations between two types of integration, hospital-physician and hospital-Post Acute Care (PAC), and their effect on cost, quality, and utilization of healthcare services as they relate to affordable care. Assessment of these impacts through the lens of financial benefits the found …

Healthcare Cost and Spending Promoting Value-Based Healthcare Decisions: A Case Study of Shared Savings Programs in New Hampshire and Maine (Pepperdine Policy Review) Christopher LaCreta and Lawson Mansell Shared savings programs (SSPs) are an emerging policy solution to combatting the rise of healthcare costs. SSPs enable patients to compare prices and receive incentives for saving money on some elective services. Researchers from Pepperdine University’s School of Public Policy recently published results from their case study on the disparities between SSPs in Maine and New Hampshire. Both states passed legislation to …

This month’s Roundup focuses on articles and reports examining price transparency efforts at both the state and federal levels as well as new recommendations for policymakers on effective healthcare cost containment strategies. States continue to address the lack of knowledge available to the public with all-payer claims databases. Federally, the implementation of new price transparency rules requiring reporting from health care providers and insurers have been examined for compliance and limitations. In addition to price transparency, to get to the bottom of healthcare affordability concerns, researchers and experts are suggesting …

Happy New Year, Source Readers! We kick off 2023 with highlights of some reports and articles that you may have missed from December. In surprise billing protection efforts, the implementation of the No Surprises Act is hitting unexpected backlogs in the IDR process, while the loophole of ground ambulance surprise bills also warrants further policy attention. Reports on healthcare spending and out-of-pocket costs suggest that healthcare is becoming less affordable as out-of-pocket costs continued to rise. Lastly, a pair of studies on value-based payment models reveal flaws in the systems …

In February of this legislative session, California Assemblymember Jim Wood introduced AB 1130, titled the California Health Care Quality and Affordability Act. Wood was prompted to draft AB 1130 when a 2020 California Health Care Foundation poll found that 84% of Californians surveyed cited health care affordability as an extremely or very important issue to them.[1] The bill would establish the Office of Healthcare Affordability (the “office”) within the Office of Statewide Health Planning and Development (OSHPD) and be tasked with analyzing health care markets for cost trends and drivers …

Happy April! This month’s roundup centers on articles and reports that discuss: 1) healthcare markets and competition; 2) payment reform, and 3) healthcare costs, and 4) price transparency.   Healthcare Markets and Competition In a piece published in the Harvard Business Review titled The Pandemic Will Fuel Consolidation in U.S. Health Care, Lovisa Gustafsson and David Blumenthal, researchers at the Commonwealth Fund, predict that mergers of key players in the U.S. healthcare system will continue as a result of provider financial challenges during the COVID-19 pandemic. While the Federal Trade …

The Source kicked off the New Year with a trio of blog posts in the Health Affairs Blog that highlights the Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ). The SLIHCQ Database was developed in partnership with the Catalyst for Payment Reform (“CPR”) and is an interactive tool that hosts ongoing state legislative efforts to implement healthcare reform. It is intuitively designed to allow policymakers and other stakeholders to customize and filter their searches by key issue and state. In collaboration with CPR, The Source Executive Editor Jaime …

Last month, we recapped the appropriations allocated to healthcare reform in the 2019 California Budget. These budget allocations, however, do not provide much guidance on how the money should be spent. Trailer bills provide the statutory language to implement the budget. With the enacted 2019 budget, the Governor signed two healthcare trailer bills passed by the Legislature, SB 78 and SB 104. In this post, we dissect these trailers bills which create and implement various programs impacting healthcare access and costs.   What are Trailer Bills? SB 78 and SB …

On June 13, using the Governor’s May Revise as a starting point, the Assembly and Senate adopted AB 74, the Budget Act of 2019, and sent it to the Governor. This bill provides in detail the Legislature’s compromise of the proposals from the Assembly, Senate, and the Governor. While this bill only provides the appropriation and not the full language of implementation, the proposed budget provides a great preview for what health reforms are in store for California. To better digest specifics of this budget compromise, we’ll break this down …

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. …