A new proposal in New York State seeks to reduce rising outpatient care costs by implementing site-neutral payment. The bill aims to cap payments, eliminate facility fees, and protect consumers from higher costs. In her latest article for CHIRblog, Karen Davenport breaks down this new proposal.
Since the early 1990s, health care provider consolidation in states like Oregon has led to higher prices, reduced access, and worsened health inequities. In response, Oregon established the Health Care Market Oversight Program in 2022 to review major health care transactions, aiming to ensure they reduce costs and improve care access, especially for underserved populations. While the program has approved most transactions so far, concerns about transparency, resource adequacy, and high profit thresholds for review persist. CHIR’s Nadia Stovicek discusses the need for ongoing evaluation and improvement, and how other states can learn from Oregon.
A recently enacted law creates a streamlined pathway to health insurance for individuals who are found ineligible for Medi-Cal but are likely eligible for Marketplace subsidies. In a recent report, CHIR experts assess the critical policy and operational decisions to implement the program and how these choices have affected consumers’ coverage transitions.
The 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) is the primary federal law protecting access to behavioral health care for privately insured Americans. In a new issue brief for the Commonwealth Fund, CHIR experts interviewed insurance regulators in ten states to identify the tools state regulators are using for MHPAEA oversight and enforcement, as well as the barriers they are facing.
While there is some movement toward improved health care provider ownership transparency at the federal level and in some states, more attention is warranted given increasingly complex and obscured provider ownership structures and the impact they can have on health care prices, access, and quality. In a recent piece for Health Affairs Forefront, CHIR experts Stacey Pogue and Nadia Stovicek analyze efforts to improve ownership transparency at the state and federal levels.
As hospitals and health systems expand their ownership and control of ambulatory care practices, they are frequently charging new facility fees for routine medical services delivered in outpatient settings. These bills are driving up premiums and health expenditures for consumers, employers, and, ultimately, tax payers. With support from and working in partnership with West Health, CHIR experts are studying outpatient facility fee billing reforms and share their findings in a new online repository.
Over the last several months, CHIR hosted the webinar series “Understanding Hospital Financing.” CHIR’s Kennah Watts reviews this series and answers timely questions relating to hospital financial health, facility fees, and the Maryland All-Payer Model.
With more outpatient care being delivered in hospital outpatient departments (HOPDs) than in previous years, consumers increasingly face high hospital facility fee charges on top of their provider’s bill for routine medical care. CHIR’s Hanan Rakine discusses the 2024 legislative session and how different states have been successful in regulating outpatient facility fees.
In a new post for the Commonwealth Fund’s To The Point blog, CHIR’s Jalisa Clark and Christine H. Monahan describe how Washington and California’s quality programs are focusing on equity and highlight opportunities for other state-based marketplaces to similarly strengthen their own quality programs.
In the United States, immigrants are disproportionately likely to be uninsured. This disparity stems from systemic inequalities such as legal barriers to affordable coverage for noncitizens—especially undocumented immigrants. While state efforts to provide Medicaid-equivalent benefits to some populations of undocumented residents have helped expand access to coverage, many low- and moderate-income undocumented residents remain without affordable health insurance options. In a recent post for the Commonwealth Fund’s To the Point blog, CHIR’s Justin Giovannelli and Rachel Schwab explore recent state actions to fill this gap.
The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.
