Private equity is not new to the health care sector, but recent growth in private equity investment has sparked a plethora of research studies, media attention, and political attention. A recent Congressional investigation and agency report, on top of continuing research indicate the time for policymakers to take action against private equity in health care is now.
The Notice of Benefit & Payment Parameters prescribes standards and rules that govern insurers and Marketplaces under the ACA. This annual regulation, that went into effect January 15, represents a final set of health insurance policies from the Biden administration focusing on quality and affordability. In their latest piece for Health Affairs Forefront, Sabrina Corlette and Jason Levitis discuss this final rule and what it means.
Since the snow shows no sign of stopping, we might as well stay cozy inside and read up on the latest health policy research from January! This month we read about patient care after private equity acquisition of hospitals, and how to improve risk-adjustment accuracy in Medicare Advantage.
Like other employer health plans across the commercial insurance market, state employee health plans (SEHPs) regularly face significant increases in health care costs. A new piece by CHIR faculty for Health Affairs explores how SEHPs’ use of provider-based reference pricing to constrain cost growth has been gaining traction.
The No Surprises Act (NSA) has largely succeeded in protecting consumers from surprise medical bills by reducing out-of-network billing and establishing a dispute resolution process. However, while compliance has improved, challenges with the IDR process, legal actions, and incomplete data hinder a full assessment of its cost containment goals and effectiveness. CHIR experts Nadia Stovicek and Jack Hoadley discuss recent complaint data in their newest piece for CHIRblog.
President Trump’s price relief memorandum calls for reducing unnecessary administrative costs and rent-seeking behavior in health care. With federal agencies empowered to gather information and potentially drive reforms to eliminate wasteful spending, CHIR’s Christine Monahan discusses how they can effectively implement this directive by investigating intermediaries like pharmacy benefit managers (PBMs) and third-party administrators (TPAs) that increase consumer and employers costs through profit-driven practices.
Right before an early executive order signaling the Trump Administration’s interest in reducing access to health coverage, House Budget Committee leadership shared a wish-list of spending cuts that will severely damage health insurance affordability for marketplace enrollees. CHIR’s Karen Davenport considers the full picture for coverage policy.
A snowy first week of January gave us plenty of time to read some of the last research from 2024. This month we read about prescription drug pricing and the impacts of rebates on consumers, as well as market shares of Medicare Advantage carriers.
The Association of Health Care Journalists has released an updated, interactive 50-state Media Guide to help journalists navigate the complexities of the U.S. health care system, offering detailed data on health insurance coverage, state policies, and regulatory agencies. Developed in partnership with Georgetown University’s Center on Health Insurance Reforms, the guide includes a national overview, state-level resources, and essential tools for reporting on health coverage and consumer experiences.
The Biden administration has advanced several pro-competition reforms aimed at lowering health care costs and increasing consumer choice, an area of potential alignment with the incoming Trump administration. CHIR’s Kennah Watts discusses competition as a bipartisan policy and what the incoming Trump administration can do to support competitive markets and improve health care affordability.
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.
