Pennsylvania’s efforts to restore competition to the provider and insurance markets in the long-standing battle between University of Pittsburgh Medical Center (UPMC) and Highmark Health overcame mounting challenges and finally concluded with an unprecedented 10-year consent decree. The Source closely tracked the case as it unfolded over the past several months. In this post, we take a look back at the case’s long and winding road, which included three stops at the Pennsylvania Supreme Court, leading up to the new truce.   It’s Déjà Vu All Over Again It all began in …

A Texas high school teacher recently made headlines after getting a $108,951 bill when a heart attack sent him to an out-of-network hospital. The ambulance rushed Drew Calver to the nearest emergency center, which his insurance did not cover, leaving him with an astronomical surprise medical bill. Unfortunately, surprise medical bills are becoming a ubiquitous part of health care in America. The question is: why? Most people have insurance, but insurance doesn’t cover everything. So when Calver was treated at an out-of-network facility, his insurance paid only $55,840 towards the …

As the holidays faded, January rang in 2015 with a return to concern about health care costs and the role of the market in health care. A number of reports came out this month on national costs. First and foremost, Health Affairs published National Health Spending in 2013: Growth Slows, Remains in Step with the Overall Economy in its January, 2015 issue. This annual report highlights national spending from the most recent data from CMS Office of the Actuary. In 2013, the U.S. spent $2.9 trillion on health care, about …