Healthcare System Mergers and Investment Models for Enhanced Health Care Market Oversight – State Attorneys General, Health Departments, and Independent Oversight Entities (Milbank Memorial Fund) Erin C. Fuse Brown, Katherine L. Gudiksen The Source’s own Katherine L. Gudiksen co-authored this report for the Milbank Memorial Fund with Eric C. Fuse Brown, which assesses the tools state policy makers are using to address harmful health care market consolidation. Specifically, the report focuses on how states have broadened review authority by expanding the existing authority of the Attorney General (or other state […]

Healthcare Costs and Spending Arriving at a Fair Price in the Medicare Drug Price Negotiation Program: Considerations from Other Countries (Health Affairs Forefront) John K. Lin, James I. Barnes, Jalpa A. Doshi, Salah Ghabri, Peter Kolominksy-Rabas, Brian O’Rourke The Centers for Medicare and Medicaid Services (CMS) are slated to begin negotiating drug prices for a subset of Medicare drugs soon, due to the Inflation Reduction Act (IRA) of 2022. Recognizing the subjectivity involved in determining fair drug prices, this article highlights the authors’ perspectives on CMS’ current strategic shortcomings and analyzes […]

In the past month, newly released publications have chronicled how partnerships, alternative payment models, and insurer market power affect competition and consolidation. Separately, researchers examined Affordable Care Act developments in terms of its impact on coverage and costs of health care. Moreover, as more and more price data are made publicly available, researchers studied how that data is presented, utilized, and what is reveals.   Competition and Consolidation Since 2005, over 190 rural hospitals have closed across the US, and today, 600 more (the nearly one third that remain) are […]

By: Erin Sclar, Student Fellow Happy February! As we eagerly await this year’s health policy valentines on Twitter, we review recent academic articles that examine a variety of issues related to health care costs, including 1) the effect of vertical integration in health care, 2) health reform and theories of cost control, 3) why the US spends so much on health care, 4) how ACOs use population segmentation to care for high-cost patients, 5) characteristics and spending patterns of high-cost Medicare patients, and 6) an evaluation of bundled payments for joint […]

By: Swaja Khanna, Student Fellow Happy November! We hope you are enjoying football season and preparing for turkey! In this edition of the Source Roundup, we cover five academic articles and reports from October. The topics this month include (1) the popularity of telemedicine for employers and employees, (2) an integrated health care system that combines ACO and bundled payment, (3) health spending growth in the coming years, (4) Maryland’s new initiative reduced hospital utilization and costs, and (5) how to remedy recent generic drug price hikes.   Telemedicine Is […]

Happy September! We hope you’ve enjoyed the Labor Day weekend and ready for the fall! In this edition of The Source Roundup, we cover five academic articles and reports from July and August. This month we look at (1) monopoly in the ACA marketplace; (2) the recent Ohio v. American Express U.S. Supreme Court decision; and a trio of articles that examine accountable care organizations in terms of (3) ACO growth in 2018; (4) ACO effectiveness in reducing health care costs; and (5) the proposed changes to ACOs in the […]

By: Megan O’Leary, Student Fellow Happy June! In this edition of the Source Roundup, we cover five academic articles and reports from April and May. The topics this month include: 1) barriers for generics to lower specialty drug prices, 2) a call to reform pharmaceutical systems in the United States and Canada, 3) efforts by states to stabilize the individual market, 4) Vermont’s push for community-driven health care reform, and 5) antitrust lawsuits in the pharmaceutical industry.   Barriers for Generics to Lower Specialty Drug Prices The Health Affairs article Generic […]

On February 16, 2018, California State Assembly Member Ash Kalra introduced Assembly Bill 3087 – The Health Care Price Relief Act, which calls for a commission to set uniform rates for medical providers, including hospitals and physicians, for the private-insurance market. The bill sets the floor for payment at the Medicare rate and places the onus on providers to apply for adjustments to the base amount.[1] AB 3087 advanced out of committee on April 25, 2018, but faces fierce opposition from doctors and hospitals, among other groups.[2] In this post, The Source […]

  Happy February! In this edition of the Source Roundup, we cover five academic articles from December and January. The topics this month include: (1) oncologists’ bias against biosimilars, (2) effects of recent mergers and acquisitions on the health system, (3) initial results from Maryland’s global budget mandate, and (4, 5) recent changes to the 340B program.   How Oncologists May Be Biased Against Biosimilars In Behavioral Economics and the Future of Biosimilars, a commentary in the Journal of the National Comprehensive Cancer Network, authors Chad Nabhan and Bruce Feinberg […]

February brought us a number of interesting articles and reports on healthcare price and competition issues. This month’s Roundup covers publications about 1) projected growth in national healthcare expenditures|2) ACA state marketplace competition|3) the relationship between payment reform and provider consolidation|and 4) the impact of the ACA on individual’s ability to buy insurance. We hope you enjoy! Projected Growth in National Health Expenditures Health Affairs published a report on National Health Expenditure Projections: 2016 – 25 by Sean P. Keehan and colleagues. According to the report, healthcare spending will continue […]