News Clips
Health Affairs: (9/14) – Leemore Dafny from the Harvard Business School and Harvard Kennedy School joins Health Affairs Editor-in-Chief Alan Weil to discuss her latest research on hospital prices and market concentration. Dafny and colleagues published a paper in the September 2021 issue of Health Affairs analyzing hospital prices and relating them to market concentration. The authors found the relationship isn't as straightforward as one might expect — but the findings still have major implications for any consideration of regulating hospital prices.
AJMC: (9/14) – In this article, authors found there has been a plateau in the number of ACOs since 2018, with ACO exits outweighing entrants for the past two years. They wrote that physician-led ACOs were more likely than other types of ACOs to leave the program. These lower entrance and survival rates are a problem for the ACO movement given the positive shared savings and quality results that many physician group–led ACOs have been able to achieve.
Fierce Healthcare: (9/13) – Policymakers have introduced proposals to combat high and rising hospital prices, but focusing on high-concentration markets likely misses the mark. The majority of high-price hospitals are active in markets that meet federal definitions of low or moderate concentration, according to a recently published commercial claims review.
Health Affairs: (September 2021) – Authors including Michael Chernew and Leemore Dafny found that most high-price hospitals are in markets that would be deemed competitive or “moderately concentrated,” using antitrust guidelines. They argue that limiting policy actions to concentrated hospital markets, particularly when those markets are defined broadly, would likely result in poor targeting of high-price hospitals. Policies that target the undesired outcome of high price directly, whether as a trigger or as a screen for action, are likely to be more effective than those that limit action based on market concentration.
Morning Consult: (9/10) – Early action from the Administration points to hospital price transparency and heightened merger scrutiny as top priorities. President Biden laid out his broad antitrust agenda in an executive order in July that singled out rural hospital closures and higher hospital prices in markets with little competition as reasons to support stronger Federal Trade Commission (FTC) guidelines for healthcare mergers. As a result, the FTC appears to be taking more time to review details on proposed mergers that may have otherwise been cleared quickly or seen as “non-problematic.”
Healthcare Finance News: (9/10) – PEPC joined 16 other national healthcare organizations in urging Department of Health and Human Services Secretary Xavier Becerra to move forward on alternative payment models as part of its strategy to achieve health equity. In a letter sent to Becerra, the groups underscored how APMs routinely leverage multidisciplinary approaches to care, assess social risk, partner with community organizations to increase access to nonmedical services and leverage data to improve disparities in patient outcomes.
MedCity News: (9/9) – In a recent survey, approximately 75 percent of employers said they plan to ramp up their implementation of value-based care models over the next three years, with many indicating they are exploring virtual care partnerships. Other goals include: Match members with experts best suited to their medical needs—and not just locally; Deliver faster, more efficient care, along with improved patient experiences; and Reduce disparities in care that affect ethnic and social minorities.
Fierce Healthcare: (9/9) – The Department of Health and Human Services (HHS) wants to test models that would pay drugs based on their clinical value as part of a new plan to tackle high prices.The plan lays out several administrative tools the agency plans to take to address high prices. It also calls on Congress to adopt several reforms such as giving Medicare price negotiation authority and cap Part D catastrophic spending.
Managed Healthcare Executive: (9/8) – To reduce the cost of care and improve health outcomes for their members, the authors argue payers will have to take a more active approach to value-based care by leveraging data to find targeted opportunities, collaborating with providers, and supporting investment in medical technology.
Modern Healthcare: (9/8) – The Centers for Medicare and Medicaid Services will turn a skeptical eye toward venture capital and private equity investments in healthcare and demand greater transparency, a key agency official said Wednesday. Pauline Lapin, director of the Center for Medicaid and Medicaid Innovation's Seamless Care Models Group, said Officials worry patients won't get the care they need if investors are only in healthcare to collect government money.
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