PRICE AND QUALITY TRANSPARENCY
The Source Roundup: April 2023 Edition
Rachel Ng, Student Fellow April 3, 2023
With the healthcare market at the most consolidated it has ever been, both federal and state action is needed to ensure health care systems provide high-quality, affordable care that is accessible. In this month’s roundup, we begin with several publications authored by The Source team on the ramifications of consolidation and the role of federal and state antitrust enforcers. Researchers also considered whether health care providers and insurers have returned to pre-pandemic performance levels. With the rise of health care spending and health care costs, understanding these trends becomes especially …
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The Source Roundup: March 2023 Edition
Rachel Ng, Student Fellow March 1, 2023
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 …
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The Source Roundup: February 2023 Edition
Rachel Ng, Student Fellow February 1, 2023
Articles and reports published in the first month of 2023 saw an increased focus on the impact of consolidation as well as private equity investment in health care. Researchers also continued to examine factors impacting health care pricing and explored potential policy options available to the states to address provider prices, including a specific call for legislative intervention in the Western Pennsylvania market. Healthcare Consolidation Recent years saw an interesting shift in healthcare consolidation: mergers and acquisitions are becoming increasingly low-volume but high-value and cross-market. In Kaufman Hall’s report …
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The Source Roundup: January 2023 Edition
Amy Y. Gu, Managing Editor January 3, 2023
Happy New Year, Source Readers! We kick off 2023 with highlights of some reports and articles that you may have missed from December. In surprise billing protection efforts, the implementation of the No Surprises Act is hitting unexpected backlogs in the IDR process, while the loophole of ground ambulance surprise bills also warrants further policy attention. Reports on healthcare spending and out-of-pocket costs suggest that healthcare is becoming less affordable as out-of-pocket costs continued to rise. Lastly, a pair of studies on value-based payment models reveal flaws in the systems …
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Recapping the 2022 California Legislative Session: What Was and What Wasn’t – Part 2: Promoting Telehealth and Tackling Out-of-Network Costs and Prescription Drug Prices
Amy Y. Gu, Managing Editor November 13, 2022
In the previous issue of the California Legislative Beat, we recapped noteworthy bills from year two of California’s 2021-2022 legislative term, specifically legislation that sought to regulate healthcare competition and ensure affordable access (see Recapping the 2022 California Legislative Session – Part 1). In this second part of the two-part series, we turn to bills that aimed to eliminate surprise out-of-network costs, advance telehealth, and rein in prescription drug prices, including ones that were signed into law and some important ones that didn’t make the cut. Surprise Out-of-Network Costs …
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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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HCA Healthcare and Mission Health Face Wave of Lawsuits for Anticompetitive Contracting
Amy Y. Gu, Managing Editor September 14, 2022
Anticompetitive contracting practices have been under antitrust enforcement scrutiny from both state regulators and private parties in recent years. In California, hospital giant Sutter Health faced several high-profile lawsuits for its alleged anticompetitive contracts. While the state case led by the California attorney general settled earlier this year, the federal class action is on its way to the 9th Circuit appeal. HCA Healthcare, a large health system in North Carolina, appear to be the next health system under litigation fire for similar practices. Three separate actions have been filed by …
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The Source Roundup: September 2022 Edition
Enne Mae Guerrero, Graduate Research Fellow September 1, 2022
In this month’s Source Roundup, we start out with the latest articles and reports that examine consolidation and lack of competition in the healthcare markets, specifically 1) the impact of certificate of public advantage legislation and 2) the impact of dialysis consolidation on Medicare Advantage beneficiaries. We also highlight a few articles discussing healthcare prices and costs, including 3) the impact of inflation on the healthcare sector, 4) the divergence in cost growth between Medicare and the private insurance sector, and 5) factors that cause health spending to rise in …
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The Source Roundup: August 2022 Edition
Amy Y. Gu, Managing Editor August 1, 2022
Summer may be going by like a breeze, but you can still catch up on some of the latest studies and reports in healthcare market and prices in the Source Roundup as usual. In this issue, we first take a look at the latest trends in hospital and health system consolidation. More than a year since the implementation of the federal hospital transparency rule, researchers continue to study and examine the hospital price data that were disclosed, including characteristics of hospitals that have complied with the rule, trends in prices …
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