Over the past 30 years, hospitals and physician practices have been merging at an accelerated pace, and as a result, they have been able to command higher prices for their services. A recent report by CHIR Faculty discusses federal and state mechanisms to address provider consolidation, and what can be done to strengthen them.
On October 3, CHIR held the first in a series of in-person policy briefings on the future of employer-sponsored insurance (ESI), sponsored by Arnold Ventures and West Health. The event, featuring remarks from U.S. Senator Maggie Hassan and a panel discussion moderated by Sarah Kliff of The New York Times, spotlighted state cost containment policies and employer strategies to inform the federal policy process concerning ESI, which covers almost half of all Americans.
The U.S. House of Representatives Education and Workforce Health Subcommittee held a hearing on health care costs, competition, and transparency. CHIR’s Christine Monahan testified before the committee regarding consolidation in health care markets.
High and rising health care prices are a key driver of increased cost sharing in employer plans. A significant contributor to rising prices is the consolidation in health care provider markets. In the third post of a series on policy options to improve the affordability of employer-sponsored insurance, CHIR’s Maanasa Kona and Sabrina Corlette explore strategies to limit provider consolidation and anti-competitive behavior.
CHIR had a lot to be thankful for this November, including new health policy research. For the latest installment of our monthly research roundup, we reviewed studies on consumer awareness of Medicaid renewals resuming when the COVID-19 public health emergency (PHE) expires, integrating health equity into value-based payment models, and trends in hospital consolidation across health care markets.
In our newest monthly roundup of health policy research, CHIR’s Emma Walsh-Alker reviews studies on the potential of personalized phone outreach to boost marketplace enrollment, trends in the small-group health insurance market, and the Congressional Budget Office’s latest report comparing how much commercial insurers and Medicare pay for health services.
This February, CHIR’s Olivia Hoppe reviewed new research on health care costs and utilization, surprise bills after in-network elective surgery, acquisition of physicians by private equity firms, and rates of charity care by nonprofit hospitals.
For several years, we at CHIR have tracked health insurance industry trends by monitoring trade and mass media, Wall Street analyses, earnings, and other reports. In 2019, we observed an increase in reporting on contract disputes between health insurers and providers. These discussions are becoming more contentious as insurers face mounting pressure to rein in health care costs while ensuring consumers’ access to providers. CHIR’s Emily Curran digs into what’s behind the trend and what it means for patients.
On October 16, Sutter Health announced that it had reached a tentative agreement to settle the class-action lawsuit against it, which alleged that the system has used its market dominance to drive up the cost of care. Though Sutter Health denied all allegations, the plaintiffs argued that the system relies on three core tactics to maintain a competitive edge, including: all-or-nothing contracting, anti-incentive contract terms, and price secrecy contract terms. CHIR’s Emily Curran and Sabrina Corlette explain these tactics and recent findings on the impacts of provider consolidation.
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.
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.
