As we prepare to transition to the summer, this month is an opportune time to examine the impacts of potentially a new season in the health care market. Researchers noted that not only is there a rise of geographically distant mergers even as rural hospitals struggle to maintain profitability, but also that private equity is a new major financier of the health care market. On the other hand, California hopes to increase competition with Golden Choice, a state-run public option. Federally, price transparency efforts could be a step towards creating […]

California’s Medi-Cal program is the largest Medicaid program in the country. It is tasked with providing care for approximately 15 million enrollees, or one third of California’s population. To ensure affordability while maintaining quality and improving health care outcomes, CalAIM was created as California’s newest approach to reform Medi-Cal, including changes to managed care plans and reimbursement of behavioral health plans. Although many of these objectives under CalAIM are still in the initial implementation stages, the potential ramifications of this multi-year, billion-dollar investment in changing how millions of people receive […]

This month’s Roundup focuses on articles and reports examining price transparency efforts at both the state and federal levels as well as new recommendations for policymakers on effective healthcare cost containment strategies. States continue to address the lack of knowledge available to the public with all-payer claims databases. Federally, the implementation of new price transparency rules requiring reporting from health care providers and insurers have been examined for compliance and limitations. In addition to price transparency, to get to the bottom of healthcare affordability concerns, researchers and experts are suggesting […]

The Source on Healthcare Price & Competition is thrilled to announce the launch of the newest interactive key issue pages in Provider Rate Regulation. Along with a report published in Frontiers in Health Services, this series of key issue pages aim to provide state policymakers with a roadmap of effective strategies to address rapidly increasing prices. In many markets, where existing competition are insufficient to constrain the pricing power of dominant insurers and providers, policymakers need to consider options to directly limit the unrelenting increase of healthcare prices that threatens the affordability of health care for Americans. With support […]

Year two of California’s 2021-2022 legislative term came to an end last month as the Governor signed 997 bills into law and vetoed 169. The state considered healthcare bills that were rolled over from 2021 as well as new ones that were introduced in 2022. At the end of the 2021 session, The Source recapped noteworthy bills impacting healthcare price and competition that were enacted (see blog post). In the 2022 session, the legislature again made efforts to promote healthcare access and affordability in California through several legislative themes. In […]

The Healthy California for All Commission, established in 2019 through Senate Bill 104, was created to advance efforts towards a health care system that delivers affordable, equitable, accessible, high quality health care for all Californians through a unified financing system. Two of the Commission recommendations have already been implemented this year. First, with the expansion of Medi-Cal eligibility to all adults between the ages of 26-49 regardless of immigration status, all California residents are now eligible for the full scope of Medi-Cal benefits. Second, the state passed legislation that established […]

This month, we are pleased to highlight new publications co-authored by The Source-affiliated health policy researchers and scholars, discussing 1) the potential benefits of all-payer hospital global budgets, and 2) the legal viability and policy effects of state public option health plans. Additionally, we examine articles covering research on 3) hospital service offerings based on ownership type, 4) the correlation between hospital prices and patient outcomes, 5) data sources within California’s physician practice landscape, and 6) the labor market impact of hospital mergers.   Healthcare Reform and Cost Containment High […]

In a new paper published in the Harvard Journal on Legislation Volume 59, Issue 1, The Source’s Jaime King and Katie Gudiksen, together with Erin Fuse Brown, discuss state public option proposals from 2010–2021, including from states like Nevada, Colorado, and Washington. In examining the three main models—(1) Medicaid Buy-In Public Options; (2) Marketplace-Based Public Options; and (3) Comprehensive Public Options—the paper considers potential challenges to these state public option plans and whether they are legally viable and “worth it” for states to pursue, given the goal of improving healthcare […]

California’s 2021-2022 legislative session reconvened on January 3, 2022, and the Assembly had the opportunity to pass critical single-payer, universal health care legislation, AB 1400, on January 31, 2022. Unfortunately, the measure did not even proceed to a vote due to the author of the bill citing a lack of necessary support. Had the measure passed the Assembly and successfully made its way through the legislative process, California could have been the first state in the country to offer comprehensive universal health care to its residents. In this post, we […]

This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See North Carolina page. North Carolina is a state that is active in antitrust enforcement in the healthcare market. In addition to prohibiting most-favored nation clauses in provider contracts, the state is also the site of a major enforcement case that alleged anticompetitive contract practice in a lawsuit against Atrium Health (formerly Carolinas Healthcare […]