Tag Archives: pay for performance

Health Policy Updates: June 19 2016

I have written in this space before about how the growth of large health care providers can contribute to the increasing cost of medical care. This week saw another couple of interesting articles on the topic.

The first reported on new evidence to support the emerging consensus that large hospital systems drive up prices as they gain monopoly power. A wave of consolidation in California has been linked to an increase in prices that its hospitals charge.

“Researchers said this gap of nearly $4,000 per patient admission was not due to regional wage differences or hospitals treating sicker patients. Rather, they said California’s two biggest hospital chains, Dignity Health and Sutter Health, had used their market power to win higher rates.” Continue reading Health Policy Updates: June 19 2016

Health Policy Updates: May 14 2016

It was deja vu all over again, when a federal court judge laid down a ruling that (if it ultimately stands) would be a severe blow to the ACA/Obamacare.

What was the legal question this time? Apparently, the ACA cannot spend money to subsidize health insurance (all of the reduced-price insurance plans on the health care exchanges) without first having appropriated the money through Congress. Read more, from Sarah Kliff at Vox, here.

“This victory in Washington isn’t the final word on the lawsuit. But it does allow it to move forward, and means that the legal battle over Obamacare — one that has already included four Supreme Court cases — still isn’t over yet.”


Hillary Clinton made the health policy news this week for new statements regarding her ideas for new health care legislation. In contrast to Bernie Sanders’ “Medicare for All” single-payer type of plan, her new proposal for expanding health insurance coverage is being characterized as “Medicare for More.”

“The Medicare program covers Americans once they reach 65. Beneficiaries pay premiums to help cover the cost of their coverage, but the government pays the bulk of the bill. Mrs. Clinton’s suggestion was that perhaps younger Americans, ‘people 55 or 50 and up,’ could voluntarily pay to join the program.” Continue reading Health Policy Updates: May 14 2016

Health Policy Updates: February 6 2016

One idea that gets discussed intermittently in both health policy circles and the popular press is that of allowing the federal government to negotiate drug prices with pharmaceutical companies. Under current law, the drug makers get to set the prices that the government pays for drugs under the Part D (Prescription Drug Act), no questions asked. It has been suggested that the government could save significant $$$ by trying to negotiate for lower prices. A recent blog piece in Health Affairs discusses what the mechanics of this might look like.

“Researchers have also concluded that the federal government could save $15.2 billion to $16 billion annually if it negotiated with drug manufacturers and achieved the same prices as those paid by Medicaid or the Veterans Health Administration (programs that receive mandatory rebates on drug prices). Other researchers have suggested that Medicare would save $541 billion over 10 years if prices were negotiated down to the levels paid for prescription drugs by consumers in Denmark.” Continue reading Health Policy Updates: February 6 2016

Health Policy Updates: January 22 2016

Bernie Sander’s new single-payer health care plan was introduced at the beginning of the week, and Ezra KIein of the left-leaning Vox media was not so keen. Big promises of new benefits, but where exactly was the money to pay for it coming from?

“All in all, Sanders wants to raise taxes by a bit over a trillion dollars per year — which may not sound like much to those who remember the Obamacare debate, but remember that the numbers that got thrown around for Obamacare were 10-year estimates. Adding inflation, Sanders will be raising taxes by close to $15 trillion when the Congressional Budget Office applies its normal scoring window.”

Continue reading Health Policy Updates: January 22 2016

Health Policy Updates: January 17 2016

The cost spiral on pharmaceuticals continues. And it isn’t just the new drugs – manufacturers continue to jack the prices on the old ones, too.

“The new increases despite this criticism “signals there’s still pricing power,” Jefferies analyst David Steinberg said in an interview. “Unlike other countries, there’s no mechanism whereby regulatory authorities can control price.”” Continue reading Health Policy Updates: January 17 2016