Healthcare Costs
Growth In National Health Expenditures: It's Not The Prices, Stupid
Health Affairs
Michael Chernew
The article seeks to identify the causes of rising healthcare costs by assessing trends across sectors, including coding intensity, AI medical services, product costs, and healthcare consolidation and administrative shifts. Chernew reports that coding intensity has increased and explores the possible relationship to AI medical services, though notes it may be too early to identify any trends. Broad healthcare infrastructure changes show conflicting trends in prices, and the author advocates for more focus on understanding evolving infrastructures and how they interact to impact prices. Chernew also addresses increased usage of expensive drugs and other products and explores potential models for price control. As early reports indicate that spending will continue to grow, Chernew advocates for reducing spending without compromising quality rather than simply shifting financial burdens to other stakeholders.
How Unaffordable Is Health Care?
JAMA Health Forum
Larry Levitt
Levitt seeks to identify an appropriate and affordable cost for healthcare by contextualizing America's disproportionate healthcare costs and how costs are distributed through employer- and government-sponsored cost-sharing plans, as well as the Premium Tax Credit. The author highlights the harms to the government, employers, and individuals caused by high healthcare expenses. Ultimately, Levitt advocates for addressing underlying healthcare costs, rather than cutting spending on healthcare or shifting the burden to workers.
Hospital Prices Post-COVID-19: Troubling Trends From California
Health Affairs
Glenn Melnick
Health insurance premiums are projected to rise significantly in 2026. This article assesses hospital price data from the California Department of Health Care Access and Information (HCAI), which demonstrates post-Covid price increases to identify cost drivers and potential stakeholders in rising hospital and healthcare costs, and the permanence of heightened costs. The article reports that hospital prices rose faster for commercial payers than for Medicare. While some evidence suggests costs are "catching up" to cost growth during the pandemic, it could also reflect persistent growth driven by structural shifts. Some insurers have reported allowing contracts to lapse when systems demanded significant increases, especially in areas where hospitals had limited competition. Delays in the availability of data and rising affordability concerns have made this an increasingly important topic. Melnick encourages future research on post-COVID commercial price trends to focus on factors driving differential pricing power across hospitals, including hospital financial characteristics.
Value-Based Payment And Managed Care Will Not Solve The Affordability Crisis
Health Affairs Forefront
Andrew M. Ryan Hayden Rooke-Ley Robert A. Berenson
The value-based payment model ties healthcare payments to quality outcomes, unlike traditional fee-for-service, which reimburses based on the volume of services provided. Value-based payments have been a popular choice for policymakers looking to address the high cost of American healthcare. The authors of this item argue that value-based payments won't solve our cost crisis as they fail to address the core drivers of healthcare spending: high prices, technology diffusion, and administrative costs.
Financial Relationships
Hospital and health system M&A in review: Uncertainty transitions to continued momentum in 2025
Kaufman Hall
This article reports data on healthcare transactions throughout 2025. The article provides quantitative reports on transactions by member affiliations and revenue, and assesses trends in persistent financial challenges, the concentration of these challenges in smaller independent hospitals, and uncertainty in federal policies. It also notes a trend in non-profit acquirers and a lack of activity by for-profit organizations.
Looking forward, the article anticipates non-acute and capability-based partnerships, portfolio diversification, heightened state regulation, and ongoing finance-driven acquisitions.
Pleading Poverty — Related-Party Payments and Health Care Entities' Financial Health
The New England Journal of Medicine
Erin C. Fuse Brown, Andrew R. Olenski, and Ashvin D. Gandhi
The article assesses the impact of related-party transactions on inhibiting government intervention in hospitals' financial struggles. Related party transactions are manipulated transactions in which healthcare entities set terms that allow them to tunnel profits and assets to related parties, impoverishing healthcare entities while enriching owners through inflated related-party earnings. This allows entities to fabricate financial distress, which can disrupt patient care and make it harder for government agencies to determine where to allocate support. The article offers a case study of such in nursing homes, following a recent bankruptcy filing by Genesis HealthCare. Brown, Olenski, and Gandhi explore how nursing homes can shift assets and the incentives to do so. The authors find that while federal nursing home transparency requirements have been implemented, initial compliance has been poor, and many reports have been incomplete and inaccurate. They suggest routine audits of cost reports, accountability under the False Claims Act, and excluding noncompliant entities from participating in Medicare and Medicaid.
The article acknowledges the prevalence of accusations of similar practices throughout the healthcare sector and advocates for greater transparency in increasing oversight and accountability to increase financial sustainability.
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