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 […]

The ongoing COVID-19 pandemic has exacerbated the issue of health care affordability in the United States. According to a Pew Research Center study, since the pandemic began, 25% of adults have had trouble paying bills, with 11% having particular difficulty in affording medical care.  Lower income Americans face an even more dire situation, with 46% having had trouble paying bills and 19% unable to afford medical care.  Already stretched thin by the pandemic, the last thing Americans across the country need is to open their mailboxes to find an unexpected […]

This month in health policy research, surprise billing and changes in market structures fuel concerns about competition and consumer choice.  In addition, some studies on pharmaceutical costs produced hopeful reports.   Healthcare Market Competition and Consolidation Consolidation Trends In a Health Affairs study, Consolidation of Providers into Health Systems Increased Substantially, 2016-18, Michael Furukawa et al. analyzed provider consolidation trends.  The rate of physician affiliation with a health system increased by 11 to 51 percent in 2018.  Based on the 556 health systems the authors identified, the median number of […]

By: Danika Rothwell, Student Fellow Paul DeWolfe needed back surgery.  He knew the operation would be covered by his insurance and was careful to make sure the hospital he chose was in his insurer’s network.  DeWolfe sat down and did the math. He figured his portion of the bill would cost roughly $3,000.  When DeWolfe recovered from his procedure, he was shocked to receive a bill for $18,590.83.[1]  Despite all his attentive preparation, some of the physicians who treated him at his in-network hospital were, in fact, out-of-network.  This story […]

By: Swaja Khanna, Student Fellow With the coronavirus pandemic causing shelter-in-place restrictions around the world, we here at The Source hope you are staying safe and healthy as we catch you up on some of the articles and reports in health policy this month. In this edition of the Source Roundup, we cover articles and reports that discuss: (1) the cost of hospital care for COVID-19 for the uninsured, (2) how health costs may change in the pandemic, (3) surprise out-of-network billing from ambulance transportation, (4) in-network ASC episodes that […]