Happy New Year! In this inaugural issue of 2022, we roundup articles and reports that you may have missed from the year end that examine various healthcare price and competition issues, including 1) an observational study on states’ merger review powers and their effect and 2) a review of policy options for addressing the extent and impact of consolidation in California. In addition, we cover articles that examine 3) the correlation between prices disclosed under the new hospital price regulation with total costs of care among commercially insured individuals, 4) …

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 North Carolina page. North Carolina is a state that is active in antitrust enforcement in the healthcare market. In addition to prohibiting most-favored nation clauses in provider contracts, the state is also the site of a major enforcement case that alleged anticompetitive contract practice in a lawsuit against Atrium Health (formerly Carolinas Healthcare …

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 Nebraska page. Nebraska has advanced several healthcare price transparency initiatives in the state. To protect patients from surprise billing, the legislature enacted the Out-of-Network Emergency Medical Care Act that prohibits providers from billing patients for medical care received from out-of-network providers or facilities in emergency situations. In addition, Nebraska patients have the ability …

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 Montana page. Montana promotes the use of telemedicine by providing coverage and cost-sharing parity between telemedicine and in-person services. Coverage for telemedicine services must be equivalent to the coverage for in-person services. To make telemedicine services more affordable to patients, cost-sharing requirements that are not generally applicable to in-person services may not be …

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 …

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 …

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. …

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 …

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 …

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 …