PRICE AND QUALITY TRANSPARENCY
California Proposes Legislation to Establish An All-Payer Claims Database – 5 Questions and Answers to Understand AB 2502
Sammy Chang, Health Policy Researcher April 19, 2018
What is AB 2502 About?To better understand healthcare costs and promote price transparency, AB 2502 proposes the establishment of an all-payer claims database (APCD) in California. In general, all-payer claims databases collect health insurance claims from all payers, which inform policymakers on how to better control healthcare costs. The bill’s intent is to understand “how to reduce health care costs while improving quality and reducing disparities”, and to encourage “health care service plans, health insurers, and providers to develop innovative approaches, services, and programs that may have the potential to deliver health …
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Are APCDs the Solution to Price Transparency in Healthcare?
Katie Gudiksen, Senior Health Policy Researcher April 16, 2018
As health care costs continue to rise, voters have identified “health care” as the top issue for the 2018 elections. In response, in March 2018, a group of bipartisan Senators asked thirty stakeholders for feedback as they develop legislation to increase price transparency in the healthcare market in order to increase competition and drive down prices for healthcare services. A lack of price transparency for health care prevents patients from shopping for medical care the way they can for other services, thereby driving up costs. There are no consistent or …
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Academic Articles & Reports Roundup: October 2017
Sammy Chang, Health Policy Researcher November 1, 2017
Happy November! In this Roundup, we cover five articles from October. The topics this month include: (1) pharma-tribal cooperation and the patent system, (2) Medicare subpopulations with the highest preventable spending, (3) privacy protections in All-Payer Claims Database legislation, (4) medical spending on autism spectrum disorder, and (5) a game theory model to understand hospital competition. Pharma-Tribal Cooperation Undermines the Patent System The Association for Accessible Medicine paper Patent-Assignment Transactions Between Brand-Name Drug Companies and Native American Tribes Will Undermine A Healthy Patent System and Harm Patients arises from Allergen’s …
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Academic Articles and Reports Roundup: January 2017
Anna Zaret, Managing Editor February 4, 2017
As we moved into the first month of 2017, we continued to see articles addressing concerns about healthcare costs and the role of the market in healthcare. This month’s Roundup covers 1) state oversight of vertical integration in healthcare|2) the influence of provider and insurer market share on price negotiations|3) frameworks for analyzing product-hopping antitrust claims|and 4) former President Obama’s comments on “repeal and delay” of the ACA. Source Executive Editor Jaime S. King and Erin Fuse Brown published The Double-Edged Sword of Health Care Integration: Consolidation and Cost Control (Indiana …
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Academic Articles & Reports Roundup: November 2016
Anna Zaret, Managing Editor December 1, 2016
Happy December! We hope everyone got some rest and had a delicious feast over the Thanksgiving holiday. Our roundup of November academic articles and reports covers publications on the following issues: (1) the effect of the Supreme Court’s decision in Gobeille on All-Payer Claims Databases (APCDs)|(2) pharmaceutical pricing|(3) price transparency tools’ impact on consumer choice of hospital|and (4) cross-market hospital mergers. APCDs In All-Payer Claims Databases – Uses and Expanded Prospects after Gobeille (New England Journal of Medicine), John D. Freedman, Linda Green, and Bruce E. Landon discuss how the …
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Academic Articles & Reports Roundup: October 2016
Anna Zaret, Managing Editor November 1, 2016
We hope you had a happy Halloween! October’s roundup includes articles covering 1) price transparency|2) provider collaborations in California|3) antitrust doctrine on state immunity|4) payment reforms|and 5) consumer healthcare costs. For the next few months, we will be using the Roundup to focus on a few great healthcare price and competition articles, rather than reporting on a wider array of articles that came out in the month. If you think we have overlooked any interesting articles, please feel free to send us what we’ve missed! Price Transparency In The New …
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Academic Articles & Reports: August 2016
Anne Marie Helm, Managing Editor September 1, 2016
This last round up of the summer features articles on a range of topics including (1) competition in healthcare markets|(2) strategies for reducing healthcare costs|(3) pharmaceutical pricing|(4) ACOs|(5) other ACA aspects and effects|(6) post-Gobeille strategies|and (7) antitrust enforcement. We hope everyone is settling into school and work after some time off. Happy (almost) fall! Competition in health care markets: In Choice and Competition in Public Service Provision, by Timothy J. Besley and James M. Malcomson, published by the Center for Economic Policy Research, looks broadly at markets involving services like …
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The Source’s Jaime King and Others on What’s Left For States After Gobeille
Anne Marie Helm, Managing Editor March 13, 2016
On March 1, the Supreme Court decided Gobeille v. Liberty Mutual Insurance Co., holding that ERISA preempted a Vermont law’s APCD reporting requirements for self-funded employee health plans (see our case brief here). This case has enormous implications for price transparency and cost containment strategies, especially at the state level. To lay out the issues and offer predictions as to Gobeille’s consequences, Health Affairs Blog ran a four-part series on the case, including one by Source Executive Editor and favorite collaborator Erin C. Fuse Brown called The Consequences Of Gobeille v. Liberty Mutual For Health Care …
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Court Rules 6-2 in Gobeille: ERISA Pre-empts VT Transparency Law
Elizabeth Nicholson, Research Fellow March 2, 2016
Today, the Supreme Court decided Gobeille v. Liberty Mutual Insurance Co. in favor of Respondent, Liberty Mutual. The Court held that ERISA does, in fact, pre-empt Vermont’s all-payer claims database (“APCD”) statute as the statute applies to ERISA plans. Earlier, we included this case brief on the Source Blog. THE MAJORITY OPINION Justice Kennedy authored the majority opinion. He was joined by Justices Roberts, Thomas, Breyer, Alito, and Kagan. In its majority opinion, the Court acknowledged that Section 1144(a) of ERISA—that “any and all state laws insofar as they may …
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Issue Brief: Gobeille v. Liberty Mutual (SCOTUS)
Elizabeth Nicholson, Research Fellow December 10, 2015
OVERVIEW The reach of All Payers Claims Database (“APCD”) legislation is currently being tested in Gobeille v. Liberty Mutual Insurance Company, Docket No. 14-181, which is presently before the U.S. Supreme Court. The case stems from Liberty Mutual’s refusal to comply with Vermont’s reporting requirements under that state’s APCD statute, which the insurer argues is preempted by The Employee Retirement Income Security Act of 1974 (“ERISA”)—a notoriously broad statute that preempts any state law that “relates to” a self-insured plan. FACTS Pursuant to Vt. Stat. Ann. Tit. 18, Section 9410, …
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