Provider Network
The Source Roundup: May 2018 Edition
Amy Y. Gu, Managing Editor May 1, 2018
Happy May! In this edition of the Source Roundup, we cover four academic articles and reports from March and April. The topics this month include: 1) the unfilled promise of price transparency to encourage price shopping, 2) FDA’s actions on prescription drug prices, 3) the phenomenon of overpayment for prescription drugs, and 4) results of Maryland’s All-Payer global hospital budgeting program. Unfulfilled Promise of Price Transparency to Encourage Price ShoppingIn Promise and Reality of Price Transparency, a health policy report published by the New England Journal of Medicine, authors Ateev Mehrotra, Michael …
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Academic Articles and Reports Roundup: February 2017
Anna Zaret, Managing Editor March 3, 2017
February brought us a number of interesting articles and reports on healthcare price and competition issues. This month’s Roundup covers publications about 1) projected growth in national healthcare expenditures|2) ACA state marketplace competition|3) the relationship between payment reform and provider consolidation|and 4) the impact of the ACA on individual’s ability to buy insurance. We hope you enjoy! Projected Growth in National Health Expenditures Health Affairs published a report on National Health Expenditure Projections: 2016 – 25 by Sean P. Keehan and colleagues. According to the report, healthcare spending will continue …
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DOJ & North Carolina AG Target Same Insurer-Provider Contract Clauses as California’s Sutter Plaintiffs
Anne Marie Helm, Managing Editor June 14, 2016
Last week, the Justice Department’s Antitrust Division, along with the North Carolina Attorney General’s Office, filed suit against Carolinas Healthcare System (“CHS”), challenging the large provider’s use of certain contract provisions in its agreements with insurers. DOJ claims that CHS, the dominant and most expensive provider in the Charlotte, North Carolina area, uses its market power to insist that the four largest insurers in the area agree not to steer their subscribers to lower-cost/higher-value providers. The last major DOJ case involving insurer-provider contracts was the Antitrust Division’s 2010 challenge to …
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Academic Articles & Reports Round Up: May 2016
Anne Marie Helm, Managing Editor June 1, 2016
Happy June! In May, healthcare scholars discussed the usual topics of healthcare price, transparency, and hospitals. And, since the third open enrollment period ended February through April 2016, journals and foundations published multiple reports and articles on state marketplaces. Enjoy! HEALTHCARE PRICE The Journal of Applied Clinical Medical Physics published an article that seeks to answer the question: Why is health care so expensive in the United States? In this op-ed, the author, a “medical physicist” presents his opinions on why healthcare is so expensive in the United States. He …
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What Drives Scalable Innovation in Healthcare? Hint: It’s Not Cost Savings, Outcomes, or Technology
Guest Author October 1, 2015
By Guest Blogger: Amanda Goltz, MPA, Industry Consultant In the avalanche of media coverage, conference sessions, and social media posts around why the $2.7 trillion healthcare industry is one of the slowest to adopt widespread innovation, there’s plenty about the barriers to change, but not a lot of what truly drives the few widespread changes that actually have happened. We understand that the third party payer system distorts business models, the practice of medicine is an art as much as a science, fee for service rewards process, not outcomes, and that …
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Academic Articles and Reports Round-Up: August 2015
Jaime S. King, Executive Editor August 31, 2015
The end of summer is always so bittersweet. As the long days filled with sun, swimming, and a bit more time for family and fun wind down, they are replaced with an undeniable excitement in the air. A promise of new opportunities and endless possibilities seems to accompany the start of the new school year. As you gear up for the fall, the August Roundup has all you need to catch up on your reading on healthcare price and competition. The August literature focused on three key topics: 1) Medicare …
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How to fix our hospital pricing problem (and how not to)
Guest Author April 15, 2015
By Guest Blogger: Erin C. Fuse Brown, JD, MPH We are pleased to publish another excellent post by Professor Fuse Brown, originally published here by the Center for Law, Health & Society! The post: Last month, Slate columnist Reihan Salam wrote a provocative article about outrageous hospital prices that are driven, according to Salam, by greed, avarice, and market power. Salam gets a few things dead right, namely his diagnosis that we have a massive hospital pricing problem that is bleeding us dry and that the problem is largely caused by growing hospital market power. However, he misses the …
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March Articles & Reports Roundup
Jaime S. King, Executive Editor April 1, 2015
It’s been a big month in health law! King v. Burwell was argued before the Supreme Court, the House voted to repeal the sustainable growth rate (SGR), a two-year CHIP extension was passed, and the Supreme Court held that physicians did not have the right to sue state Medicaid programs for greater reimbursements in Armstrong v. Exceptional Child Center. While you were busy reading about these and countless other developments in our ever changing healthcare system, quite a bit has been published related to healthcare prices and competition. This month’s …
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February Articles & Reports Roundup
Jaime S. King, Executive Editor March 2, 2015
In February, we saw assessments of health policy ideas from the level of national health reform right down to very specific cost saving initiatives. This issue of the Roundup will start with the broad and theoretical and move toward the specific. Big picture health reform In Managed Competition in Health Insurance, Stanford economists Liran Einav and Jonathan Levin examine the potential for regulated markets to outperform single payer public insurance. Specifically, they examined the use of managed competition in Medicare as a means of demonstrating how adverse selection and market …
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January Articles & Reports Round Up
Jaime S. King, Executive Editor February 1, 2015
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 …
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