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 …

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 …

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 …

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, …

This month, our round-up proudly features a new issue brief written by our Source colleagues that discuss what state regulators need to strengthen state antitrust laws and prevent further healthcare provider consolidation. Also highlighted in this month’s round-up are studies on the potential impact of the federal No Surprises Act on health care prices, state-level strategies to reduce health care spending, better methods to assess policy-relevant financial information of hospitals, a grassroots push towards the public option, and industry trends and implications in the pharmacy market.   Market Competition/Consolidation In …

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 …

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, …

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 …

This month’s roundup covers academic articles and reports that examined: 1) early results and challenges of the new federal price transparency rule; 2) how to address increasing market consolidation and competition during the COVID-19 pandemic; 3) rising healthcare costs; and 4) how much patients pay and physicians receive when patients receive out-of-network emergency care.   Price Transparency In response to policymakers calling for greater price transparency of healthcare services for patients and other payers of healthcare, a federal rule from the Department of Health and Human Services took effect on …

With the inauguration of a new administration in the White House, discussions ramped up on the future of health care and new legislative and regulatory possibilities. This month’s Roundup begins with three articles that look at ways to strengthen the Affordable Care Act (ACA) as well as the potential for more significant health reform through the implementation of a public option. On the price transparency front, we cover a report that looks at the effect of New Jersey’s final-offer arbitration system for resolving surprise billing disputes and the new price …