State Hospital Price Caps
Modern Healthcare has a good article on various state initiatives to regulate hospital prices. Proposals range from hard caps to looser standards. Coincidentally, I had a blog on Thursday covering many of the same states and initiatives. Check it out here: https://www.healthcarelabyrinth.com/states-attack-healthcare-costs-and-hospital-prices/
In related news, healthcare policy group KFF issued a briefer on hospital competition in the U.S. The analysis examines the competitiveness of markets for hospital care based on RAND Hospital Data and American Hospital Association (AHA) survey data.
It found that one or two health systems controlled the entire market for inpatient hospital care in nearly half (47%) of metropolitan areas in 2024. In more than four of five metropolitan areas (83%), one or two health systems controlled more than 75% of the market. Nearly all (97% of) metropolitan areas had highly concentrated markets for inpatient hospital care.
KFF also says that most hospital markets in metropolitan areas (80%) became less competitive from 2015 to 2024 or were controlled by one health system over that entire period.
Additional article: https://www.kff.org/health-costs/one-or-two-health-systems-controlled-the-entire-market-for-inpatient-hospital-care-in-nearly-half-of-metropolitan-areas/
(Some articles may require a subscription.)
#hospitals #rates #coverage #healthcare
https://www.modernhealthcare.com/providers/mh-hospital-price-cap-legislation-indiana-vermont
Trump Admin Touts Fraud Reduction
The Trump administration has been claiming major wins against fraud in healthcare but demanding more regulations and laws to battle what is an out-of-control problem.
It is highlighting its moves against fraudulent enrollment in the Exchanges via the One Big Beautiful Bill Act (OBBBA) and regulations it has enacted. In these changes, eligibility is restricted or eliminated for some groups, eligibility gates have been increased for others, documentation has been added, and brokers and marketing practices reined in.
Additional article: https://www.fiercehealthcare.com/regulatory/trump-team-claims-successes-against-aca-fraud-while-pushing-more-controls
(Some articles may require a subscription.)
#fwa #medicare #medicaid #exchanges #cms
https://www.modernhealthcare.com/politics-regulation/mh-trump-aca-fraud-marketplace-regulations
— Marc S. Ryan
