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 …

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 …

In an op-ed written for the Wall Street Journal on September 19, 2017, Seema Verma, the new administrator for the Centers for Medicare &amp|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 …

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under Medicare Part B. This pilot reform attempt has been on hold for more than a year, but CMS has now officially withdrawn it.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 …

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 …

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, …

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 …

We hope you all had a great Thanksgiving, full of friends, family, and cheer! November yielded some interesting articles and perspectives on health care markets and consolidation, price transparency, payment reform, prescription drug pricing, more ACA litigation, and health care spending. Enjoy! HEALTH CARE MARKETS/CONSOLIDATION Multiple articles discussed the effects of health care markets and consolidation on various health care entities. Early in November, the Alliance for Health Reform published an article entitled Health Care Consolidation. The article uses numbers and statistics to paint a vivid picture of the increase in …

Greetings! For the academics among us, its time to wrap up your end of the year grading and see what you’ve been missing in the literature this month. Two themes came out of the literature in May. First, (no surprise to anyone) the American public continues to be frustrated with the lack of transparency and rationality in healthcare prices, but there are some signs of hope. Second, policymakers and academics have proposed numerous payment reforms, which despite their varying degrees of success, only get at a fraction of the problem. …

Articles and Reports Round Up: June 2014 Greetings! In this installment of the Articles and Reports Round Up are the Source’s pick reads from the academic literature and policy reports from June 2014. Academic Articles Health Affairs’ June issue, titled The Economics of Health Care: Costs, Savings, and Value (be still our hearts), had two lead articles on healthcare consolidation and costs (Ginsburg and Pawlson, and Sage) followed by two commentaries. All four are well worth reading. Paul Ginsburg and Gregory Pawlson’s article, Seeking Lower Prices Where Providers Are Consolidated: An …