High and rising healthcare costs in the U.S. are driven largely by escalating hospital prices, fueled by increasing consolidation among health systems. In a recent Issue Brief for the Milbank Memorial Fund, Sabrina Corlette and Karen Davenport discuss what states can do to enhance premium rate review programs, to ultimately curb provider price increases.
A case before the Supreme Court and a new Secretary of the U.S. Department of Health & Human Services could substantially weaken the ACA’s guarantee of no-cost preventive services in private insurance. Experts Sabrina Corlette and Tara Straw provide a roadmap for state policymakers to protect their residents, in a recent article for State Health and Value Strategies.
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 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.
