New Georgetown CHIR Report Finds Ability of Insurers, Employers to Respond to Provider Consolidation is Limited

A new Georgetown CHIR report synthesizing the case studies of 6 health care markets finds that insurers and employer-purchasers have limited tools and incentives to effectively counter the market clout of increasingly consolidated provider systems. With a lack of market-based solutions, the report raises questions about whether and what policy interventions might be needed. Continue reading

New Georgetown CHIR Report: In Trump Era, States Revisit the Benefits and Risks of Running Their Own Health Care Marketplace

Half a dozen states have announced they will transition from HealthCare.gov to their own, state-run health insurance marketplaces. In a new report with the Urban Institute, CHIR researchers assess states’ reasons for making the switch, risks and benefits, and considerations for policymakers in other states contemplating a similar move. Continue reading

Stakeholders Weigh in on the Risk Corridor Litigation: Are Public-Private Partnerships At Risk?

On December 10, the U.S. Supreme Court will hear oral arguments in Maine Community Health Options v. U.S., a case concerning the Affordable Care Act’s risk corridors program. This month, nine stakeholders filed amicus briefs in preparation of the arguments and we reviewed these briefs to identify common themes. One key theme emerged from the stakeholders reviewed: that the Court’s decision could negatively impact public-private partnerships. Continue reading

Disputes over Dispute Resolution: Analyses of New York & California-style Surprise Billing Protections Offer Divergent Pictures

The U.S. Congressional Budget Office (CBO) has a new analysis of legislation that would protect patients from surprise medical bills and help settle physician-insurer payment disputes through an arbitration process. CHIR’s Sabrina Corlette takes a look at their projections and three recent assessments of the effect of balance billing laws in New York and California Continue reading

Will it Fly? Wyoming Attempts End Run Around High Air Ambulance Prices

Air ambulance charges are a significant source of surprise out-of-network bills for many patients, with charges running into 5 figures. States have been frustrated in their efforts to protect consumers in this context due to a federal law preempting regulation of air carrier prices, including air ambulances. However, the state of Wyoming may have hit on a unique solution – effectively making air ambulance a public utility. Will it work? CHIR’s Sabrina Corlette takes a look. Continue reading

Successfully Splitting the Baby: Design Considerations for Federal Balance Billing Legislation

The U.S. Congress is advancing legislation to protect patients from surprise medical bills. Yet consensus on how to resolve payment disputes between providers and health plans has been difficult to reach. In their latest post for the Health Affairs Blog, Sabrina Corlette, Jack Hoadley, and Kevin Lucia break down different policy approaches, their pros and cons, and how recent state action could suggest a path forward. Continue reading