PRICE AND QUALITY TRANSPARENCY
The Source Roundup: July 2022 Edition
Enne Mae Guerrero, Graduate Research Fellow July 1, 2022
Happy Summer! We kick off the holiday weekend with the latest research and articles in healthcare price and competition. This month’s Roundup highlights articles and reports that discuss 1) the impact and trends of private equity investment in health care; 2) compliance trends of the federal Hospital Price Transparency Rule; and 3) the role of high prices in excess healthcare spending in the U.S. and possible strategies for cost containment, including methods to limit costs and spending, such as 4) health savings accounts, 5) out-of-pocket spending limit for Medicare, and …
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Q2 2022: Antitrust Enforcement Actions Flourish Against Healthcare Consolidation and Anticompetitive Contracting
Amy Y. Gu, Managing Editor June 14, 2022
It’s been a busy month in healthcare antitrust land, both for federal regulators and private plaintiffs, as we saw an explosion of enforcement actions challenging both proposed mergers and anticompetitive conduct that stemmed from previous mergers. From New Jersey to Utah, large health systems such as HCA are being increasingly scrutinized and coming under fire for garnering and using their market power in anticompetitive ways. Merger Challenges Fresh from its appeals court win in the Hackensack Meridian and Englewood merger challenge, the Federal Trade Commission (FTC) is continuing its …
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AB 2080: A Statutory Solution to Addressing Anticompetitive Transaction & Behavior in the Healthcare Market
Enne Mae Guerrero, Graduate Research Fellow May 16, 2022
Consistent research has shown that consolidation in the health industry leads to an increase in healthcare costs without improved quality of care. Though many healthcare mergers have previously gone unchecked, antitrust enforcers are increasingly using their statutory and regulatory authority and the court system to address healthcare consolidation concerns.[1] In California, the attorney general has had the statutory authority to review non-profit hospital mergers for decades but the limited oversight does not extend over all anticompetitive transactions and behavior. This session, the legislature introduced AB 2080 aimed to broaden existing …
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California’s 2022-23 Budget Proposal Builds Upon Enduring Goals of Healthcare Access and Affordability
Enne Mae Guerrero, Graduate Research Fellow April 14, 2022
In January, Governor Gavin Newsom unveiled California’s 2022-23 state budget proposal—dubbed the California Blueprint—which proposes spending $286.4 billion in total state funds.[1] As the California Blueprint acknowledges, “[t]oo many Californians find themselves on the wrong end of income inequality – crushed by the rising costs of the most basic expenses like healthcare.”[2] With proposed investments to tackle health care issues facing the state, the Governor’s 2022-23 budget proposal addresses healthcare inequality, access, and affordability in a number of ways—such as in establishing an Office of Health Care Affordability; creating universal …
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The Source Roundup: March 2022 Edition
Hannah Park, Student Fellow March 1, 2022
This month’s Roundup includes articles on healthcare merger review, specifically new policy recommendations that explain 1) why regressing price on the HHI does not inform merger analysis, and 2) how courts can implement health equity concerns in merger review. Next, we examine articles that evaluate potential strategies to reduce healthcare costs, including 3) state initiatives that build on past improvement efforts, and 4) financial incentives to reward patients for choosing lower-priced providers. Finally, we look at 5) trends in outpatient telehealth use since the start of the pandemic, and 6) …
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The Source Roundup: January 2022 Edition
Hannah Park, Student Fellow January 3, 2022
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) …
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Spotlight on State: North Carolina
Amy Y. Gu, Managing Editor December 14, 2021
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 …
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Spotlight on State: Nebraska
Hannah Park, Student Fellow December 6, 2021
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 …
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Spotlight on State: Montana
Hannah Park, Student Fellow November 23, 2021
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 …
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Recapping the 2021 Session: Healthcare Legislation Passed in California
Enne Mae Guerrero, Graduate Research Fellow November 14, 2021
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 …
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