We did it again! The Source on Healthcare Price & Competition is proud to announce that, in partnership with UC Berkeley’s Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, we have launched another brand new interactive key issue page, “Provider Contracts”, which looks at the most effective strategies for states to understand and address the ability of providers with dominant market power to utilize contracting strategies to negotiate high rates. With support from Arnold Ventures, this new installment is part of a collaborative research series that leverages the latest and most comprehensive data on state laws, healthcare markets, and healthcare prices in provider …

In this edition of the Source Roundup, we highlight articles and reports from February that discuss: (1) the prevalence of out-of-network billing during elective procedures with in-network services, (2) affordable care organizations’ potential to limit out-of-network spending, (3) findings from the new Health Care Cost and Utilization Report, (4) private health care spending growth  varies by hospital referral regions, (5) U.S. has highest healthcare spending despite worst health outcome, and (6) how states policies encourage provider market competition and lower healthcare spending.   The Prevalence of In-Network Care that Result …

SAN FRANCISCO, Calif. – February 25, 2020 – High commercial health care prices are a main driver of US health care spending, due in large part to consolidation among providers. While employers, other health care purchasers and payers can drive competition in the marketplace through benefit and provider network design, public policies can also strengthen and support those efforts. Catalyst for Payment Reform and The Source on Healthcare Price and Competition at UC Hastings College of the Law have catalogued state measures to enhance market competitiveness and control costs through legislation. The report, State Policies …

Early in January, the Department of Justice (DOJ), along with the Federal Trade Commission (FTC), released a new draft guideline for vertical merger review and sought public comments. On February 24, The Source Executor Editor Jaime King, along with health economists and policy experts including Source Advisory members Tim Greaney and Richard Scheffler, jointly released “Comments on the Draft Vertical Merger Guidelines with Special Consideration to Health Care”. The comments raise concerns and urge that special attention be paid to the effects of vertical mergers in the health care sector, …

Happy February!  Here at The Source, we are grateful for the extra day in February to give our readers time to catch up with the latest health policy analysis and literature.  This edition of the Source Roundup looks at articles and reports on 1) how monopolies have hurt consumers and what states can do to combat hospital acquisitions and mergers, 2) how well states are doing to make health care affordable; 3) why a single-payer system is financially feasible; and 4) what the United States can learn from other countries’ …

In California and elsewhere, the closure of emergency departments (“ED”) reduces access and negatively affects patient health, particularly to the primary users of EDs, who are often low-income and most affected by the closure. In 2014, the American College of Emergency Physicians (ACEP) observed that California had the lowest number of EDs per capita[1] and gave California an “F”, ranking the state 42nd in the country in terms of access to emergency care.[2] However, California’s latest attempt to strengthen state oversight over ED closures faltered when Governor Newsom vetoed AB …

See UFCW & Employers Benefit Trust v. Sutter Health case page.   The high-profile antitrust case against Sutter Health settled on the eve of trial in October 2019, when the Northern California hospital giant reached a preliminary settlement agreement with the California Attorney General’s office and class action plaintiffs after five years of litigation. The terms of the settlement were released late December, which include both monetary compensation for the private plaintiffs and injunctions against Sutter’s conduct that will restore competition and promote transparency in the provider market. In this …

On January 10, the Department of Justice (DOJ), along with the Federal Trade Commission (FTC), released a new draft guideline for vertical merger review. As opposed to horizontal mergers, vertical mergers generally combine entities that operate at different levels in the same supply chain. As vertical mergers become more commonplace in the healthcare industry, they are increasingly raising antitrust concerns as they often times don’t trigger the same level of scrutiny as do horizontal mergers. The much needed new guidelines specifically targeting vertical mergers serve to withdraw and update the …

On January 10, California Governor Gavin Newsom released his 2020-2021 State Budget proposal. While the state budget process will not begin in earnest until after the Governor’s May Revise, the state budget provides a glimpse of likely California health care reforms. The Governor’s January Budget Proposal proposes the following: Proposal Goals Office of Health Care Affordability Increase price and quality transparency Develop cost targets for health care industry Address hospital cost trends by region, with focus on cost increases driven by delivery system consolidation Establish standards for advance evidence-based and …

Happy New Year! We hope you had an exciting start to the new decade! In this edition of the Source Roundup, we cover articles and reports from December that discuss: (1) increase in US health care spending in 2018, (2) health system affiliation and how it affects patient access, (3) out-of-network provider charges between 2012 and 2017, and (4) how billing in-network could save millions.   U.S. Health Care Spending Increased 4.6 Percent to Reach $3.6 Trillion in 2018 In the Health Affairs article National Health Care Spending in 2018: …