Insurance and Provider Markets
Our work in Insurance and Provider Markets
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Even if it Survives the Courts, ObamaCare Needs Help
In an op-ed for The Hill, Schaeffer Center professor John Romley and Cedars-Sinai president and CEO Thomas Priselac write that step one to fix the ACA is accepting that payment cuts and cost shaming do not work.
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Reducing Unfair Out-of-Network Billing — Integrated Approaches to Protecting Patients
It may be possible to balance the competing goals of consumer protection and market innovation in state and federal oversight of health plan networks, according to a new opinion piece in The New England Journal of Medicine.
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Effects of Weakening Safeguards in the Administration’s Health Reimbursement Arrangement Proposal
Researchers from the USC-Brookings Schaeffer Initiative for Health Policy discuss the negative effects of allowing firms to subsidize the purchase of individual market coverage and why the associated costs are likely to outweigh the benefits to employers and their workers.
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Texas Ruling Over Obamacare is Wrong to Claim That Without the Insurance Mandate, the Healthcare Law Can’t Survive
The Affordable Care Act’s insurance markets are stable, even without a penalty for those who don’t have coverage.
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Characteristics of Physicians Excluded From US Medicare and State Public Insurance Programs for Fraud, Health Crimes, or Unlawful Prescribing of Controlled Substances
The number of physicians excluded from participation in Medicare and state public insurance reimbursement owing to fraud, waste, and abuse increased on average, 20 percent per year, between 2007 and 2017.
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23nd Annual Wall Street Comes to Washington Healthcare Roundtable
Paul Ginsburg will discuss what the latest market developments mean for national health policy and how federal policies may affect the outlook for healthcare companies with Wall Street analysts.
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Payment and Delivery-System Reform — The Next Phase
In The New England Journal of Medicine, Paul Ginsburg discusses the next phase of value-based payment systems and how healthcare payers and purchasers can ensure providers’ past investments become permanent reforms to the payment and care delivery process.
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Blame Emergency Rooms for the Out-of-Control Cost of Health Care
Glenn Melnick argues hospital groups and public policy are to blame for exorbitant emergency room costs for patients in an op-ed for The New York Times.
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The California Competitive Model: How Has it Fared, and What’s Next?
The combined effect of policies and consolidation trends was a substantial reduction in the competitiveness of provider markets in California, which reduced health plans’ ability to leverage competitive provider markets and negotiate lower prices and other benefits for their members.
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How Would Individual Market Premiums Change in 2019 in a Stable Policy Environment?
Matthew Fielder examines how premiums would change in 2019 absent recent policy changes that are set to take effect.
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