HEALTHCARE MARKETS
FTC Restores and Implements Prior Approval Rule with Provision in DaVita Divestiture Order
Amy Y. Gu, Managing Editor November 15, 2021
In July 2021, President Biden’s executive order called on federal agencies to strengthen antitrust enforcement in the healthcare industry to promote and revitalize healthcare competition and price transparency in the U.S. In response to the call to action, the agencies, particularly the Federal Trade Commission (FTC), have mobilized and stepped up their efforts by providing additional guidance and oversight of consolidation in the healthcare market. In this issue of Litigation and Enforcement Highlights, we take a look at the FTC’s reinstatement and implementation of the prior approval rule, the latest …
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Recapping the 2021 Session: Healthcare Legislation Passed in California
Enne Mae Guerrero, Graduate Research Fellow November 14, 2021
In the 2021 legislative session, California’s democratic-held legislature has passed roughly 800 bills, 770 of which have been enacted after approval by Governor Newsom.[1] A number of bills impacting the healthcare industry passed overwhelmingly in both houses, yet a couple of critical bills were vetoed. Notably, the COVID-19 pandemic, which shifted legislative focus away from healthcare costs in 2020, has amplified the various pitfalls of the healthcare system. This session, the legislature returned to propose several bills to mitigate these shortcomings and address healthcare costs and access. This post summarizes …
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New Documentary Exposes the Alarming Trend of Hospital Monopolies and the Impact on Costs
Amy Y. Gu, Managing Editor November 8, 2021
The new film InHospitable is a timely documentary that follows patients and activists as they battle UPMC, a multi-billion dollar nonprofit hospital system that was making vital care unaffordable for hundreds of thousands of vulnerable patients in western Pennsylvania. The film highlights the urgency of holding large health systems accountable for their significant role in our broken healthcare system. Slated to have its world premiere on November 13th at DOC NYC, anyone in the U.S. can watch it online from November 14 – 28. Tickets are available here for in-person …
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Spotlight on State: New Mexico
Amy Y. Gu, Managing Editor November 2, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See New Mexico page. New Mexico has made strides in healthcare price transparency and cost control. After a legislative mandate was enacted to establish an all-payer claims database, the state began its implementation with budget allotted in the 2019-2020 fiscal year. In recent terms, New Mexico also passed the Surprise Billing Protection Act, which …
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The Source Roundup: November 2021 Edition
Hannah Park, Student Fellow November 1, 2021
As hospital consolidation continue to rise amidst the pandemic, there has been contentious debate over the impacts of provider consolidation. This month’s roundup begins with articles that discuss some of these issues, including studies that found both benefits and potential harms of certain hospital mergers, acquisitions, and partnerships. Also highlighted in this month’s roundup are studies on the implications of proposed payment reforms across specialties, increasing health care costs for individuals with employer-sponsored insurance, and the continuing lack of plan comparison among Medicare beneficiaries during open enrollment season. Market …
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Mining Audited Financial Statements to Better Assess Health System Financial Strength and Inform Policy Decisions
Guest Author October 28, 2021
By: Robert A. Berenson, M.D. The lead story in the October 5, 2021 issue of the Washington Post regarding hospital finances during the coronavirus pandemic highlighted an American Hospital Association spokesperson’s recent assertion that “the delta variant has wreaked havoc on hospitals and health systems.” The article explained that staff shortages were raising staff salaries substantially, leading to “excess labor costs,” which, in combination with a new round of deferred elective procedures during the most recent surge of the delta variant, has reduced hospital profit margins and cash flow. …
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Spotlight on State: Missouri
Hannah Park, Student Fellow October 26, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Missouri page. Missouri has long recognized the benefits of telehealth in increasing access to healthcare. To encourage providers to adopt telehealth services, the state has passed parity laws requiring health plans to provide coverage and reimbursement for telehealth services at the same basis and rate as they would for in-person services. Access to …
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Spotlight on State: Mississippi
Hannah Park, Student Fellow and Amy Y. Gu, Managing Editor October 25, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Mississippi page. Mississippi has been active in promoting telehealth services, as one of the first states to enact parity laws for telehealth services in the state. Since before the COVID-19 pandemic, the state has had comprehensive parity laws that require health plans to cover and reimburse telehealth services on the same basis and …
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Webinar Recording Available: State Approaches to Mitigating Health Provider Consolidation and Its Effects on Prices
Amy Y. Gu, Managing Editor October 21, 2021
On October 21, the Milbank Memorial Fund and the Source on Healthcare Price and Competition hosted a webinar on steps that states are taking to foster more competitive health care markets and lower health care prices, featuring The Source Senior Health Policy Researcher Katie Gudiksen and state regulators from Connecticut and Oregon. The recording is now available to watch for free: Watch Recording Download Powerpoint Presentation (Katie Gudiksen) For more information, check out the 3-part Milbank Memorial Bank series authored by the Source team. The first brief called for collaboration of state and …
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Spotlight on State: Oklahoma
Amy Y. Gu, Managing Editor October 20, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Oklahoma page. Oklahoma operates a volunteer all-payer claims database. Approximately 1 million people’s claims are in this database, accounting for about 25% of Oklahoma’s total population. The legislature also introduced legislation to promote price transparency and cost containment in recent terms, including protection against surprise billing and a Right to Shop program that …
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