PRICE AND QUALITY TRANSPARENCY
The Source Roundup: August 2021 Edition
Hannah Park, Student Fellow August 2, 2021
The COVID-19 pandemic has caused the American healthcare system to undergo drastic changes in a matter of months. Coupled with a new presidential administration, the health care system is likely to evolve. The Biden administration has already taken action on a number of key health policy areas in which significant changes might occur. In light of these changes, health policy experts are thinking about what health care will look like in the post-pandemic world. This month’s Roundup covers new research on 1) the impact and benefits of the No Surprises …
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Spotlight on State: Oregon
Michele Ellson, Student Fellow July 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 Oregon page. Oregon is a leader in efforts to provide affordable, high-quality health care to every state resident. State lawmakers approved a proposed constitutional amendment that would provide Oregon residents the right to cost-effective, appropriate, and affordable health care, which will go to the voters. Lawmakers have also tasked the state health authority …
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Spotlight on State: Alaska
Amy Y. Gu, Managing Editor July 21, 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 Alaska page. According to data from the Council for Community and Economic Research, health services in Alaska are 70 – 200 percent more expensive than the national average. Many pressures influence Alaska’s health-care costs. They include expenses related to recruiting providers from out of state, lack of competition, the state’s small population. In …
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Spotlight on State: Alabama
Amy Y. Gu, Managing Editor July 19, 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 Alabama page. Alabama is one of the few states that prohibits most non-compete provisions in employment contracts for professionals, which include physicians. Specifically, the courts held that statutory exemptions allowing non-competes in employment contracts do not apply to professionals and that physicians and other medical providers are professionals under state law. While the …
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Spotlight on State: Rhode Island
Michele Ellson, Student Fellow and Amy Y. Gu, Managing Editor July 15, 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 Rhode Island page. Rhode Island is an active state in advancing innovative policy initiatives to promote healthcare competition, price transparency, and cost containment. The state has long operated an all-payer claims database and additionally requires hospitals to provide patients with a cost estimate of anticipated services. The state also provides some limited protections …
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Spotlight on State: Ohio
Michele Ellson, Student Fellow and Amy Y. Gu, Managing Editor July 13, 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 Ohio page. Ohio lawmakers have made strides in healthcare price transparency in recent sessions despite previous setbacks. In 2021, the state eliminated surprise medical bills for HMO and PPO enrollees for emergency services provided by out-of-network professionals, facilities, and ground ambulance service providers, and non-emergency services provided by out-of-network professionals at in-network facilities. …
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Biden Executive Order Seeks to Tackle Healthcare Consolidation and Boost Competition
Amy Y. Gu, Managing Editor July 12, 2021
In an encouraging boost to efforts to promote healthcare competition and price transparency, President Biden signed a sweeping executive order that targets consolidation and lack of competition in the healthcare industry, among others. As part of the Executive Order on Promoting Competition in the American Economy released on July 9th, the President targeted specific market players in the healthcare sector, including hospitals, health insurers, and prescription drug manufacturers. The Executive Order affirms the policy of the Biden Administration “to enforce the antitrust laws to combat the excessive concentration of industry, …
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Spotlight on State: New Jersey
Michele Ellson, Student Fellow July 9, 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 Jersey page. New Jersey is active in state market initiatives with a state-based insurance marketplace, Covered NJ, and a state-based reinsurance program that partially reimburses insurers for certain claims. In recent terms, New Jersey lawmakers are also considering legislation that would create a single-payer health plan by expanding Medicare to cover all of …
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The Source Roundup: July 2021 Edition
Michele Ellson, Student Fellow July 1, 2021
This month, we are proud to announce the publication of an issue brief by our Source colleagues Katherine L. Gudiksen, Alexandra D. Montague, and Jamie S. King on the topic of healthcare market consolidation—and more specifically, on what state and federal leaders are doing to deal with it. This month’s Roundup also discusses new research about a potential link between ACO participation and higher prices, hospitals’ lagging price transparency compliance efforts, surprise ambulance bills, the future of telehealth, enrollee satisfaction with public and private health plans, and state employee health …
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Spotlight on State: Florida
Amy Y. Gu, Managing Editor June 7, 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 Florida page. Florida is an active state in promoting healthcare price transparency. A key effort is the state’s all-payer claims database, which was mandated by the legislature and implemented in 2016. It also has a consumer-facing website, FloridaHealthFinder, which allows consumers to view performance and outcome data, including average costs, for healthcare facilities …
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