HEALTHCARE SYSTEM REFORM
Governor Newsom’s Healthcare Budget Proposal for 2025-26
Dilani Logan, Student Fellow February 7, 2025
On January 10, 2025, Governor Newsom released his proposed California state budget for the 2025-26 term. Following last year’s $46 billion budget shortfall, the Governor’s new budget looked quite different this year. Specifically, the budget had no deficits, reporting a projected surplus of $363 million due to the state’s prediction that it will collect almost $17 billion more in revenue than was originally planned. In fact, this year is slated to go down as California’s second-largest state spending plan ever, at a value of almost $322 billion. Overview of the […]
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The Source Roundup: February 2025 Edition
Kassie Williams February 1, 2025
Healthcare Pricing Can Public Option Plans Improve Affordability? Insights From Colorado (Health Affairs Forefront) Roslyn Murray, Christopher M. Whaley In the face of individuals and families unable to afford increasing insurance premiums due to lack of healthcare insurance competition, a variety of states are considering offering public option plans, commonly for ACA Exchange plans. These plans seek to provide coverage with low premiums by means of capped prices for those who do not meet Medicare or Medicaid requirements nor receive private coverage through employment. The article describes Colorado’s effective public […]
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Recapping the 2024 California Legislative Session, Part 2: Legislative Bills That Didn’t Pass
Kassie Williams January 8, 2025
The California legislation concluded the 2024 legislative session when it adjourned on August 21, 2024. Overall, the legislature introduced a variety of health care bills spanning a list of hot-topic issues from Medi-Cal eligibility to health care worker minimum wage increases. Below we recap noteworthy bills from the 2024 legislative session impacting California’s health care market that were not enacted (to learn what bills were enacted please see Recapping the 2024 California Legislative Session: Artificial Intelligence, Debt, and More). The bills covered are arranged by issue relating to Pharmaceuticals, Health […]
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The Source Roundup: January 2025 Edition
Dilani Logan, Student Fellow January 2, 2025
Price Transparency Hospital Payment Caps Could Save State Employee Health Plans Millions While Keeping Hospital Operating Margins Healthy (Health Affairs) Roslyn C. Murray, Christopher M. Whaley, Erin C. Fuse Brown, Andrew M. Ryan As health insurance premiums continue to rise, state employee health plans are occupying an increasing portion of state budgets. State employers are often the largest purchaser or commercial health insurance in each state, given the volume of employees that they employ. As such, state governments are placed in a unique negotiating position to implement cost containment strategies. […]
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California AB 2063 Extends Risk-Bearing Arrangement Pilot Program
Kassie Williams November 7, 2024
On September 28, 2024, Governor Newsom approved Assembly Bill 2063. The provisions of the bill were originally enacted as AB 1124 in 2020, amends section 1343.3 of the Health and Safety Code regarding risk-bearing arrangement pilot programs. These programs, according to the bill’s author, Assemblyman Brian Maienschein, are a solution to increasing health care costs through shared financial risks. Background The California Department of Managed Health Care (DMHC) regulates the licensure process in the state under the Knox-Keene Health Care Service Act of 1975 (KKA). Entities required to obtain a […]
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The Source Roundup: September 2024 Edition
Dilani Logan, Student Fellow September 1, 2024
Healthcare Competition and Consolidation Vertical Integration and Market Consolidation in Healthcare: Policy Drivers and Impact on Physicians and Patient Care (Seminars in Colon and Rectal Surgery) Rachel Ekaireb, Anna Yap, and Robert Kucejko Over the past several decades, the healthcare market has become increasingly consolidated. For instance, in the last twelve years alone, the percentage of physicians employed by hospitals or healthcare systems has more than doubled from 26% to 55%. While proponents for vertical integration have touted its potential to improve the efficiency and quality of care delivery, empirical […]
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The Source Roundup: August 2024 Edition
Bruce Allain, Managing Editor August 1, 2024
Healthcare Competition and Consolidation Medicare Advantage and Consolidation’s New Frontier — The Danger of UnitedHealthcare for All (New England Journal of Medicine) Hayden Rooke-Ley, Soleil Shah, and Erin C. Fuse Brown This article describes the recent ransomware attack on Change Healthcare and the ownership structure of UnitedHealth Group, including how much market power it has with medical claims, data analytics, insurance, physicians, PBMs, pharmacies and a bank. The authors note the risks involved in these types of conglomerations, including market abuses that raise costs, erode quality of care, and harm […]
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The Source Roundup: July 2024 Edition
Kassie Williams July 1, 2024
Mergers, Acquisitions and Healthcare Competition Is There Too Little Antitrust Enforcement in the U.S. Hospital Sector? (American Economic Association) Zarek Brot-Goldberg, Zack Cooper, Stuart Craig, Lev Klarnet From 2002 to 2020, there were more than 1,100 hospital mergers with a 1% enforcement rate by the FTC resulting in only 13 blocked transactions. The authors of this study speculate low rates of enforcement could be due to factors including budgetary issues and jurisprudence that favors mergers. It is estimated these mergers resulted in a high concentration of hospital markets in “90% […]
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The Source Roundup: June 2024 Edition
Kassie Williams June 1, 2024
Effects of Market Consolidation Cost, Quality, and Utilization After Hospital-Physician and Hospital-Post Acute Care Vertical Integration: A Systematic Review (Medical Care Research and Review) Alexandra Harris, Sarah Philbin, Brady Post, Neil Jordan, Molly Beestrum, Richard Epstein, Megan McHugh To determine the impact of vertical integration, the authors examine the associations between two types of integration, hospital-physician and hospital-Post Acute Care (PAC), and their effect on cost, quality, and utilization of healthcare services as they relate to affordable care. Assessment of these impacts through the lens of financial benefits the found […]
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The Source Roundup: May 2024 Edition
Dilani Logan, Student Fellow May 1, 2024
Healthcare Cost and Spending Promoting Value-Based Healthcare Decisions: A Case Study of Shared Savings Programs in New Hampshire and Maine (Pepperdine Policy Review) Christopher LaCreta and Lawson Mansell Shared savings programs (SSPs) are an emerging policy solution to combatting the rise of healthcare costs. SSPs enable patients to compare prices and receive incentives for saving money on some elective services. Researchers from Pepperdine University’s School of Public Policy recently published results from their case study on the disparities between SSPs in Maine and New Hampshire. Both states passed legislation to […]
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