The Federal Push for Transparency Since the Affordable Care Act (ACA) was enacted in 2010, there has been a push for comprehensive healthcare reform, including early efforts to create price transparency. The ACA requires health plans to provide a summary of benefits and coverage, along with a list of definitions to facilitate consumer comprehension. In 2019, President Trump issued Executive Order (EO) 13877, which directed federal agencies to give patients access to real prices rather than estimates and to make pricing information comparable across health plans. Following that Executive Order, […]

This month’s Roundup focuses on articles and reports examining price transparency efforts at both the state and federal levels as well as new recommendations for policymakers on effective healthcare cost containment strategies. States continue to address the lack of knowledge available to the public with all-payer claims databases. Federally, the implementation of new price transparency rules requiring reporting from health care providers and insurers have been examined for compliance and limitations. In addition to price transparency, to get to the bottom of healthcare affordability concerns, researchers and experts are suggesting […]

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, […]

Happy New Year Source readers! In this month’s roundup, we take a look back at the last health policy articles of 2020 and look ahead to what 2021 holds. These pieces examine the continuing rise of national healthcare spending, the impacts of health market consolidation under the guise of healthcare delivery integration, the importance of state-level all-claims payer databases (APCDs), and the potential healthcare system reforms under the Biden administration.   Healthcare Costs Underpinning most topics in this roundup is the issue of healthcare costs, prices, and spending. According to […]

Last month, we discussed California healthcare proposals that were postponed or cut due to budget constraints brought on by the pandemic-induced recession. California’s proposed all-payers claims database (APCD) project, the Health Care Payments Data (HPD) Program, was one proposal that survived. The passage of the HPD Program demonstrates the Legislature’s understanding that health care price transparency is important enough to withstand an extreme budget crunch. In this post, we take a look at the specifics of California’s new APCD and answer some important questions about its implementation and what it […]

[Press Release] BERKELEY, CA – May 5, 2020 – Around 40% of Americans could not cover an unexpected $400 expense in 2018, which is less than one-third of the average health insurance deductible for an individual that year. Health care costs and deductibles have since continued to rise, along with the need for American consumers to have access to price information. Catalyst for Payment Reform (CPR) looked for laws in each state that ensure such transparency and today, the grades are in. CPR developed the 2020 Report Card on State […]

SAN FRANCISCO, Calif. – February 25, 2020 – High commercial health care prices are a main driver of US health care spending, due in large part to consolidation among providers. While employers, other health care purchasers and payers can drive competition in the marketplace through benefit and provider network design, public policies can also strengthen and support those efforts. Catalyst for Payment Reform and The Source on Healthcare Price and Competition at UC Hastings College of the Law have catalogued state measures to enhance market competitiveness and control costs through legislation. The report, State Policies […]

Urban Institute Research Report (January 2020) “Addressing Health Care Market Consolidation and High Prices The Role of the States” Authors: Robert A. Berenson, Jaime S. King, Katherine L. Gudiksen, Roslyn Murray, Adele Shartzer

By: Hayden Soria, Student Fellow Happy August! Even as the summer winds down, there is no waning of health policy literature. In this month’s Source Roundup, we take a look at academic articles and studies that analyze 1) potential prescription drug savings from generics and biosimilars, 2) the need for price transparency, and 4) a multitude of efforts in health system reform.   Potential Prescription Drug Savings from Generics and Biosimilars As prescription drug pricing continue to capture the nation’s attention, Stacie B. Dusetzina et al. take a dive into cost […]

Many health care providers and payers seek to maintain the confidentiality of amounts paid for services as trade secrets, claiming their secrecy provides a competitive advantage. With support from the California Health Care Foundation (CHCF), The Source’s Katie Gudiksen, Sammy Chang, and Jaime King examine the legal and economic implications of collecting and releasing this data in the newly published report, The Secret of Health Care Prices: Why Transparency Is in the Public Interest.  Part I of this report reviews trade secret statutes and case law regarding the protection of negotiated […]