PRICE AND QUALITY TRANSPARENCY
The Crisis of COVID-19 Heightens the Need for Surprise Billing Protections
Katie Gudiksen, Senior Health Policy Researcher April 20, 2020
[Post Updated: April 20, 2020] Earlier this year, the federal government appeared poised to address the problem of surprise billing,[1] but the coronavirus pandemic shifted policy priorities before Congress had a chance to act. While some lawmakers may try to include surprise billing protections in the next COVID-19 stimulus package, the pandemic and its ripple effects make action by lawmakers to address surprise billing critical. Surprise bills, also known as balance bills, may occur when a patient unavoidably sees an out-of-network provider for an emergency situation or unexpectedly sees an …
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The Source Roundup: April 2020 Edition
Ada Shao, Student Fellow April 1, 2020
We hope that you and loved ones are staying well as we together persevere through the unprecedented circumstances brought on by the COVID-19 pandemic. The current situation has brought to the forefront a number of issues our healthcare system currently faces, including the potential costs associated with treating those affected by COVID-19. In this month’s Source Roundup, we begin by looking at the expected treatment costs for patients affected by COVID-19 and examine how price capping may be a means to reduce healthcare costs. We also highlight articles that discuss …
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[Publication] JAMA Health Forum Article Highlights The SLIHCQ Database
Jaime S. King, Executive Editor March 9, 2020
Hot off the press: JAMA Health Forum article Promoting Health Care Transparency via State Legislative Efforts highlights state health transparency legislation from The State Laws Impacting Healthcare Cost (SLIHCQ) Database, a public database established by The Source on Healthcare Price and Competition and Catalyst for Payment Reform (CPR). The article looks at specific examples of state transparency legislation catalogued in the database including: All-payer claims database (APCD) – New Hampshire, Colorado Right-to-shop – Maine, Utah Surprise or balance billing – New York Find out details of these state legislation and …
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The Source Roundup: March 2020 Edition
Source Fellow March 1, 2020
By: Swaja Khanna, Student Fellow In this edition of the Source Roundup, we highlight articles and reports from February that discuss: (1) the prevalence of out-of-network billing during elective procedures with in-network services, (2) affordable care organizations’ potential to limit out-of-network spending, (3) findings from the new Health Care Cost and Utilization Report, (4) private health care spending growth varies by hospital referral regions, (5) U.S. has highest healthcare spending despite worst health outcome, and (6) how states policies encourage provider market competition and lower healthcare spending. The Prevalence …
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[Press Release] States Increasingly Turn to Legislation to Promote Competition and Control Health Care Prices, Per New Analysis from CPR and UC Hastings
Amy Y. Gu, Managing Editor February 25, 2020
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 …
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Litigation and Enforcement Highlights – February 2020
Amy Y. Gu, Managing Editor February 18, 2020
The Source has been closely following legal challenges to state legislation that seek to promote competition and contain costs in healthcare services. In this month’s Litigation and Enforcement Highlights, we roundup the latest developments in some of the pending cases as well as new lawsuits that have been filed to derail state efforts to address rising prescription drug costs. Arkansas: Supreme Court Grants Review of PBM Law In November 2019, the Source Blog covered the long litigious history of lawsuits filed against various pharmacy benefit manager (PBM) laws from …
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[Presentation] National Academy of Medicine’s Leadership Consortium: Collaboration for a Value & Science-Driven Learning Health System
Jaime S. King, Executive Editor February 13, 2020
The National Academy of Medicine’s Leadership Consortium: Collaboration for a Value & Science-Driven Learning Health System Value Incentives & Systems Action Collaborative Presentation: “Affordability in Health Care: The Roles of Consolidation and Price Transparency”
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[Sutter Case Watch] A Huge Deal: Settlement Terms of Sutter Health Antitrust Case Will Promote Transparency and Competition in California Provider Markets
Amy Y. Gu, Managing Editor January 15, 2020
See UFCW & Employers Benefit Trust v. Sutter Health case page. The high-profile antitrust case against Sutter Health settled on the eve of trial in October 2019, when the Northern California hospital giant reached a preliminary settlement agreement with the California Attorney General’s office and class action plaintiffs after five years of litigation. The terms of the settlement were released late December, which include both monetary compensation for the private plaintiffs and injunctions against Sutter’s conduct that will restore competition and promote transparency in the provider market. In this …
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[In the Press] Interview Quoted in California Healthline Article “Loopholes Limit New California Law To Guard Against Lofty Air Ambulance Bills”
Sammy Chang, Health Policy Researcher January 13, 2020
Health Policy Researcher Sammy Chang was quoted in the 1/13/2020 California Healthline article “Loopholes Limit New California Law To Guard Against Lofty Air Ambulance Bills”: “It’s a very big step in balance billing, but it’s not a definitive one,” said Samuel Chang, a health policy researcher at the Source on Healthcare Price and Competition, a project of the University of California-Hastings.
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[Publication] Addressing Health Care Market Consolidation and High Prices: The Role of the States
Amy Y. Gu, Managing Editor January 13, 2020
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
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