Insurance and Provider Markets
Our work in Insurance and Provider Markets
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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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Doctors Hold the Key to Lower Drug Prices
Contracts should raise awareness of cost without hurting patients’ access to necessary care. argues Senior Fellow Bob Kocher and his colleague Peter Orszag.
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Stabilizing and Strengthening the Individual Health Insurance Market
Mark Hall examines the causes of instability in the individual market and identifies measures to help improve stability based off of interviews with key stakeholders in 10 states.
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(De)stabilizing the ACA’s Individual Market: A View from the States
Market stabilization is currently the most critical regulatory issue that public policy officials are facing. We present strategies for stabilizing the individual market.
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Fixing Health Care: Driving Value Through Smart Purchasing and Policy
Alex Azar outlined the challenges and opportunities for public and private action in the healthcare system.
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