HEALTHCARE SYSTEM REFORM
Affordable Care Act Hanging by a Thread in the Legal Tug of War
Source Fellow April 11, 2019
By: Katie Beyer, Student Fellow In 2018, the Trump Administration issued a number of new regulations that gutted the Affordable Care Act (ACA) by effectively eliminating the ACA’s safeguards and benefits. A multitude of lawsuits brought by cities, states and health plans challenging these administrative initiatives quickly followed suit. This post provides a litigation update on the prominent cases that highlight these challenges. There are three primary categories of lawsuits at issue: (1) state challenges on the constitutionality of the ACA’s Individual Mandate; (2) city challenges on the Trump Administration’s regulatory …
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The Source Roundup: April 2019 Edition
Source Fellow April 1, 2019
By: Erin Sclar, Student Fellow Spring is finally here! With it, we review articles and reports about 1) single payer health plans and universal health care, 2) the causes, effects, and possible solutions to rising prescription drug pricing, and 3) health care costs and price transparency. Single Payer Health Plans and Universal Health Care The terms “single payer health plans” and “universal health care” are becoming increasingly familiar as the 2020 elections approach. But the meanings of these terms, and the specific policies and proposals associated with them, are often …
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AB 744 and Other 2019 Bills Seek to Increase and Improve Telehealth Delivery in California
Sammy Chang, Health Policy Researcher March 31, 2019
Avoid driving, get help instantly. That’s the premise of telehealth. Telehealth, under California law, is defined as “the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care.”[1] One study has shown that the use of telehealth, in California, has been found to save a patient 278 miles in driving, 4 hours in time, and $156 in direct travel costs per consultation.[2] As such, telehealth has been used as an …
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Innovations in State Medicaid Programs to Control Prescription Drug Costs
Katie Gudiksen, Senior Health Policy Researcher March 7, 2019
Medicaid serves nearly one in five Americans, including many with chronic conditions, and purchases about 10% of total prescription medications dispensed in the U.S.[1] From 2013 to 2016, Medicaid’s nationwide drug spending increased almost 50%, from $22.4 billion to $33.4 billion.[2] Medicaid programs consume an increasing percentage of state budgets and threaten to overtake funding for other programs like education and infrastructure.[3] In 2018, the National Association of State Budget Officers (NASBO) estimated that Medicaid accounted for nearly 30% of total state spending and is the fastest growing component of …
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The Source Roundup: March 2019 Edition
Source Fellow March 1, 2019
By: Leah S. Gray, Student Fellow Happy March! This month we take a look at articles that examine 1) state health system reform efforts, 2) protections against surprise medical bills, 3) effects of market concentration on cost and quality, and 4) ways to control rising costs for health care and pharmaceuticals. States are taking the lead in health system reform While the federal health policy debate has remained rather stagnant, states have stepped up protect their citizens from rising health care costs. North Carolina is poised to make rapid, unprecedented …
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The Issues with Prior Authorization and Why Reform Is Needed
Source Fellow February 25, 2019
By: Swaja Khanna, Student Fellow Late last year, in the middle of the holiday season, I needed a prescription medication urgently. My physician prescribed it on December 13th. I received the medication on December 20th. It took a whole week to get a medication that I should have long finished by the time I actually received it. I was deeply frustrated not only because I was physically ill, but also because I was dealing with a great deal of uncertainty. When I attempted to pick up my medication from the …
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Governor Newsom Makes Big Steps Towards Establishing California as the Nation’s Leader in Health Care Policy
Source Fellow February 5, 2019
By: Leah S. Gray, Student Fellow On his first day as the Governor of California, Gavin Newsom made his first steps towards carrying out his health care campaign promise of universal health care. Additionally, two parts of his plan look like a direct rebuke of the Trump administration, as Newsom hopes to ensure health coverage for undocumented young people and impose the individual mandate, which Congress attempted to repeal, in California. He also used his first executive orders to work towards lowering the cost of prescription drugs and to create California’s …
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The Source Roundup: February 2019 Edition
Source Fellow February 1, 2019
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 …
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Crystal Ball Predictions for 2019 – Amazon Prime Healthcare is Going to Change Everything
Source Fellow January 24, 2019
By: Jake Winton, Student Fellow The times of healthcare, as Nobel laureate Bob Dylan would say – are a changin’.[1] With annual U.S. health spending quickly approaching $4 trillion[2] and on track to be 20% of GDP[3] by 2026, we are in desperate need of change. While most of the recent chatter around healthcare spending focused on regulatory reforms or reducing benefits offered by health plans, these discussions neglect one of the most effective levers of change – technology innovation. Enter Amazon, a customer-centric delivery system that conquers industries by cutting …
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Beyond Price Shopping: How Stakeholders Utilize All-Payer Claims Databases to Address Rising Health Care Costs
Tiffany Wang, Student Fellow and Megan O'Leary, Student Fellow January 22, 2019
Since 2005, Americans have identified the availability and cost of health care as one of their top concerns. Health care costs have risen due to various factors, such as reliance on fee-for-service payment systems, lack of patient engagement, and lack of coordination and management. In recent years, state legislatures have focused on increasing price transparency in the hopes that it will drive down health care costs by encouraging consumer price shopping. One means of promoting price transparency is through the use of database tools, such as state-mandated all-payer claims databases …
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