PRICE AND QUALITY TRANSPARENCY
Spotlight on State: New Mexico
Amy Y. Gu, Managing Editor November 2, 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 New Mexico page. New Mexico has made strides in healthcare price transparency and cost control. After a legislative mandate was enacted to establish an all-payer claims database, the state began its implementation with budget allotted in the 2019-2020 fiscal year. In recent terms, New Mexico also passed the Surprise Billing Protection Act, which …
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Mining Audited Financial Statements to Better Assess Health System Financial Strength and Inform Policy Decisions
Guest Author October 28, 2021
By: Robert A. Berenson, M.D. The lead story in the October 5, 2021 issue of the Washington Post regarding hospital finances during the coronavirus pandemic highlighted an American Hospital Association spokesperson’s recent assertion that “the delta variant has wreaked havoc on hospitals and health systems.” The article explained that staff shortages were raising staff salaries substantially, leading to “excess labor costs,” which, in combination with a new round of deferred elective procedures during the most recent surge of the delta variant, has reduced hospital profit margins and cash flow. …
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Spotlight on State: Missouri
Hannah Park, Student Fellow October 26, 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 Missouri page. Missouri has long recognized the benefits of telehealth in increasing access to healthcare. To encourage providers to adopt telehealth services, the state has passed parity laws requiring health plans to provide coverage and reimbursement for telehealth services at the same basis and rate as they would for in-person services. Access to …
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Spotlight on State: Mississippi
Hannah Park, Student Fellow and Amy Y. Gu, Managing Editor October 25, 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 Mississippi page. Mississippi has been active in promoting telehealth services, as one of the first states to enact parity laws for telehealth services in the state. Since before the COVID-19 pandemic, the state has had comprehensive parity laws that require health plans to cover and reimburse telehealth services on the same basis and …
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Spotlight on State: Oklahoma
Amy Y. Gu, Managing Editor October 20, 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 Oklahoma page. Oklahoma operates a volunteer all-payer claims database. Approximately 1 million people’s claims are in this database, accounting for about 25% of Oklahoma’s total population. The legislature also introduced legislation to promote price transparency and cost containment in recent terms, including protection against surprise billing and a Right to Shop program that …
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Spotlight on State: Louisiana
Hannah Park, Student Fellow October 18, 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 Louisiana page. Louisiana has been active in legislative efforts to promote price transparency in health care. In recent terms, the state legislature introduced bills to tackle surprise billing by out-of-network specialists, proposing that patients should only be responsible for deductibles and copayment amounts that they would under the in-network terms of their insurance …
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Spotlight on State: Iowa
Hannah Park, Student Fellow October 8, 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 Iowa page. Iowa has been active in introducing state market initiatives as part of the state’s healthcare reform efforts. In 2019, legislators pursued a bill establishing a single-payer system for the state. The proposed system, called the Healthy Iowa Program, would have provided comprehensive universal single-payer healthcare coverage and a healthcare cost control …
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Spotlight on State: Kentucky
Hannah Park, Student Fellow October 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 Kentucky page. The Kentucky legislature has consistently pursued legislation aimed at improving access to healthcare price information to help rein in costs. In recent terms, Kentucky has enacted a number of legislation pertaining to prescription drug cost transparency, with particular focus on pharmacy benefit managers, including a law that prohibits PBMs from requiring …
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Spotlight on State: Pennsylvania
Amy Y. Gu, Managing Editor October 5, 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 Pennsylvania page. Pennsylvania is a leader in antitrust enforcement of its healthcare provider market with a robust set of review protocol for nonprofit hospital transactions. The state attorney general has oversight authority which requires notice of all nonprofit health entity transactions with review and based on consideration of public interest and antitrust implications. …
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Spotlight on State: Idaho
Hannah Park, Student Fellow October 4, 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 Idaho page. Idaho has stepped up its efforts to promote price transparency and control healthcare costs in recent legislative sessions. Signed into law in 2020, the Idaho Patient Act adds transparency to the medical billing process and protects consumers from unfair medical debt collection practices. The state legislature also made a notable effort …
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