Rate Regulation
Office of Health Care Affordability: California’s Healthcare Cost Commission Gears Up for Implementation
Rachel Ng, Student Fellow and Amy Y. Gu, Managing Editor December 14, 2022
In the 2022 session, California enacted legislation to create the state’s healthcare cost commission, the Office of Healthcare Affordability (OHCA). As part of the Department of Health Care Access and Information (HCAI), OHCA is authorized to analyze the health care market for cost trends and drivers of spending and set and enforce cost-growth benchmarks for the state. It also has the authority to review and assess the impact of mergers, acquisitions, affiliations, and other healthcare transactions on price and competition. As OHCA prepares for its launch, the California Health Care Foundation …
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The Source Launches New “Provider Rate Regulation” Interactive Key Issue Pages
Amy Y. Gu, Managing Editor December 1, 2022
The Source on Healthcare Price & Competition is thrilled to announce the launch of the newest interactive key issue pages in Provider Rate Regulation. Along with a report published in Frontiers in Health Services, this series of key issue pages aim to provide state policymakers with a roadmap of effective strategies to address rapidly increasing prices. In many markets, where existing competition are insufficient to constrain the pricing power of dominant insurers and providers, policymakers need to consider options to directly limit the unrelenting increase of healthcare prices that threatens the affordability of health care for Americans. With support …
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The Source Roundup: November 2022 Edition
Rachel Ng, Student Fellow and Amy Y. Gu, Managing Editor November 1, 2022
In this month’s Roundup, we highlight some noteworthy articles and reports that discuss 1) state options for provider rate regulation and their potential pitfalls such as regulatory failure and regulatory capture; 2) consolidation trends in the hospital market and pharmaceutical industry; 3) price transparency efforts including compliance with the hospital and insurer transparency rules and the state-federal partnership to implement the No Surprises Act; and 4) drivers of national health spending. Provider Rate Regulation With the rapid consolidation of health care providers and highly concentrated insurance markets, consumer bargaining …
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The Source Roundup: October 2022 Edition
Amy Y. Gu, Managing Editor October 3, 2022
Fall is upon us, and the time is better than ever to sip on a cup of tea (or coffee) and catch up on some of the latest articles and reports! In this month’s Source Roundup, we cover a variety of topics in healthcare price and competition. First, we shine the spotlight on the rise in private equity acquisitions, particularly of physician practices and ambulatory surgical centers, and highlight some of the latest studies that examine the implications of these acquisitions on healthcare cost and spending, utilization, and quality. Second, …
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California Establishes Office of Healthcare Affordability with Approval of 2022-2023 State Budget
Robin Davison, Senior Health Policy Researcher July 15, 2022
On June 30, California Governor Gavin Newsom signed the 2022-2023 state budget, which includes a trailer bill (SB 184) that provides funding to establish the highly anticipated Office of Healthcare Affordability (OHCA) within the Department of Health Care Access and Information (HCAI). California joins a number of other states including Massachusetts, Oregon, and Rhode Island, as it becomes the latest state to establish a healthcare cost commission. This is a promising step forward in California’s efforts to control health care costs while ensuring high quality and broad accessibility. The main …
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California AG Considers Cross-Market Effects in Merger Review and Conditional Approval of USC Health System and Methodist Hospital Affiliation
Amy Y. Gu, Managing Editor July 14, 2022
As federal agencies including the FTC and DOJ step up antitrust enforcement efforts in response to Biden’s executive order to revamp competition in the healthcare market, more and more healthcare entities are turning to less traditional consolidation that did not previously trigger antitrust scrutiny, such as “cross-market” mergers, which involve providers that do not directly compete in the same geographic market.[1] This month in Litigation and Enforcement Highlights, we take a look at the latest merger review and conditional approval of a proposed cross-market transaction in California, the third of …
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Rate Regulation Can Help Redirect Providers to Compete on Non-Price Dimensions of Care
Robert Murray, Senior Health Policy Researcher July 8, 2022
This Blog provides supplementary comments on the recent Health Affairs article entitled “How Price Regulation Is Needed To Advance Market Competition” authored by Robert Berenson and Robert Murray.[1] The idea for the article was stimulated by conversations Bob Berenson and I have had in recent years regarding government administered pricing systems and market competition. Conventional U.S. health policy has asserted that these two approaches represent mutually exclusive strategies to address the issue of high and rapidly rising commercial health care prices. In our Health Affairs article, we attempt to refute …
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The Source Roundup: June 2022 Edition
Enne Mae Guerrero, Graduate Research Fellow June 1, 2022
This month’s Roundup highlights articles and reports discussing the need for improved, adequate monitoring of healthcare consolidation, including 1) vertical integration and joint contracting between physicians and hospital and 2) pharmaceutical mergers. We also examine articles studying healthcare cost affordability, specifically 3) the significant disparities in prices paid to hospitals by private plans and Medicare and 4) California’s improvements in healthcare affordability and access. Finally, we look at some proposed cost containment strategies such as 5) key areas to improve competition to reduce costs and 6) price caps on out-of-network …
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California Pushes Ahead the Office of Health Care Affordability with Renewed Budgetary Support
Enne Mae Guerrero, Graduate Research Fellow March 15, 2022
Healthcare costs have grown exponentially in California[1], and Californians have indicated that it is a core issue they want the Governor and Legislature to address and remedy. In a 2021 poll, Californians expressed almost unanimous demand for action, as 82% of Californians said it is “extremely” or “very” important for the Governor and Legislature to make health care more affordable.[2] While rising healthcare costs seem to be a national problem, Californians pay more for common health services than the rest of the country, with an additional cost disparity between northern …
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The Source Roundup: February 2022 Edition
Hannah Park, Student Fellow February 1, 2022
This month’s roundup focuses on articles and reports highlighting new research and insights relating to the high and rising costs of health care, which remain a major regulatory challenge for state and federal policymakers across the nation. First, we examine 1) research discussing potential strategies for price regulation and how it could support market competition, as well as 2) proposals for price growth caps via insurance rate review. Also highlighted in this month’s roundup are studies on healthcare costs, specifically 3) state-level trends in the overall cost of employer health …
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