The September issue of Health Affairs was a special edition, focusing on the topic of health care market concentration in the US. I’ve pointed to the closely related issue of hospital consolidation as one of the biggest drivers of increasing health care costs.
As one of the featured studies in this special issue found, the health care market in the US continues to concentrate, with more and more health systems merging into larger and larger networks. The end result of this is not more efficient care for the patient, but simply higher prices, as these large networks exert their monopoly power:
“Although provider concentration could produce efficiencies that benefit purchasers of health care services, the evidence does not point in that direction. For example, reviews of studies of hospital markets have found that concentrated markets are associated with higher hospital prices, with price increases often exceeding 20 percent when mergers occur in such markets. Of even greater concern, the reviews found that these price increases did not appear to improve quality: In some cases, higher hospital concentration was associated with higher mortality rates.”
Continue reading Health Policy Updates: September 9 2017
One of the first (the first?) actions that Donald Trump took as president was an executive order to begin to dismantle the ACA. Authors at The Incidental Economist reviewed all the things that could be accomplished by executive order alone, without any additional action from Congress.
“Whether and which actions a Trump HHS chooses to pursue will depend on the administration’s willingness to gamble the stability—already quite fragile, in some states—of the individual market. And it will depend, too, on what Congress is willing to do through legislation.” Continue reading Health Policy Updates: January 28 2017
A large part of the ACA/Obamacare was to expand Medicaid; many (though not all) states elected to do so. New data out this week in JAMA Internal Medicine suggests that patients are benefiting. Compared to states that did not expand Medicaid, previously uninsured patients who have now gained access to Medicaid coverage do better on many metrics, including better access to outpatient care, increased diabetes screening, and reduced non-compliance due to cost.
The Oregon Medicaid experiment from a few years ago left Medicaid skeptics with some reason to be agnostic as to whether Medicaid actually improves people’s health. These data lessen the foundation for such skepticism, and should thus should help move the conversation forward. Continue reading Health Policy Updates: August 14 2016
With the prices of many new specialty pharmaceuticals skyrocketing, the number of patients qualifying for Medicare’s “catastrophic” prescription drug provision is skyrocketing as well.
“Experts say the rapid rise in spending for pricey drugs threatens to make the popular prescription benefit financially unsustainable. Nonpartisan congressional advisers at the Medicare Payment Advisory Commission have called for an overhaul. The presidential candidates, as well as the Obama administration, have proposed giving Medicare legal authority to negotiate prices.”
Continue reading Health Policy Updates: July 31 2016
For anyone interested in the health care spending (and its growth) in the Unites States, Health Affairs has recently given a great historical review of the topic. This post tracks the rate of growth since the 1960s, and also offers some explanation as to why the rate of growth has slowed or accelerated at different times.
“The growth in prices for personal health care goods and services averaged 4.7 percent between 1961 and 2013, faster than the average growth in economy-wide prices (as measured by the GDP price index) of 3.5 percent over the period. The year-to-year differences in personal health care and economy-wide price growth reflect excess medical inflation, which has varied significantly over time.” Continue reading Health Policy Updates: November 29 2015