Recent Publications
- Private Equity and Your Doctor: Profits Before Patients | Public Policy & Aging Report
By Richard M. Scheffler, Ola Abdelhadi | Published April 21, 2023 in Oxford Academic | Link to Full Article
Older Americans have unique health needs that require specialized care and support. As people age, they are more likely to develop multiple chronic conditions such as cancer, diabetes, heart disease, and arthritis, which can greatly affect their quality of life (Boyd et al., 2019). Additionally, older adults may also experience physical and cognitive declines, which can make it difficult for them to manage their own healthcare. Access to healthcare and supportive services is crucial for older Americans to maintain their health and independence. Services such as home healthcare, nursing homes, and hospice care play a vital role in helping older adults lead fulfilling lives and maintain their quality of life for as long as possible. The majority of hospice patients are diagnosed with one or more chronic conditions, with cancer being the most common (29.6%), followed by circulatory or heart disease (17.4%) and dementia (15.6%) (Hospice Facts & Figures, 2020). Meanwhile, as the American population of persons aged 65 years and over will soon outnumber those under 18 year of age, there are concerns about the quality of care for older Americans as the healthcare industry shifts towards private equity (PE) ownership (Braun, Stevenson, et al., 2021).
- Association Between a Capitated, Low-cost, County-Based Public Health Insurance Option and Affordable Care Act Premium Growth in California
By Arjun Teotia, Daniel R. Arnold, Richard M. Scheffler | Published April 21, 2023 in JAMA Health Network | Link to Full Article
Is a low-cost, county-based public insurance option associated with slower premium growth on the California Affordable Care Act exchange?
On Covered California (CC), the state-run Affordable Care Act (ACA) exchange in California, gross annual premiums for members have increased by 41% since CC started in 2014 ($9612 in 2022 vs $6804 in 2014).1 Through CC, individuals and their families can purchase private health insurance plans. Exchange coverage is generally intended for those who do not have access to health insurance through their employer, Medicare, or Medicaid. Nearly 90% of CC enrollees receive subsidized coverage in the form of reduced (often 0) premiums and reduced cost sharing.1 California is one of the few states that uses an active purchaser model for its exchange, which allows it to standardize benefits and cost sharing, selectively contract with insurers, and negotiate premiums.2 Premiums and insurers vary across the 19 regions of CC. Los Angeles (LA) has some of the lowest premiums and premium growth rates on CC. It is also the only region with a public plan—LA Care—which competes with 6 private insurers on the exchange.
Our work extends this research and is the first known study to empirically evaluate how a county-based public option performs in the ACA Marketplace in California. Specifically, we statistically evaluated whether LA Care was associated with reduced premium growth in LA compared with premium growth in other regions of CC.
Recent Research in the Media
- UC Berkeley Public Health Researchers Presented “Golden Choice: A Proposed Public Option Plan to Increase Competition and Lower Health Insurance Premiums” In the State Capitol
Spearheaded by Richard Scheffler, Distinguished Professor Emeritus, and Stephen Shortell, Distinguished Professor Emeritus and Dean Emeritus, the research team carried out their vision of going from pen to policy. The team shared findings about a potential public option plan for the state with state legislators, stakeholders, and press. This plan would lower healthcare costs while maintaining quality for Californians. With a prominent discussion panel moderated by the Deputy Cabinet Secretary and featuring various healthcare pioneers, insightful questions were answered, swaying doubts were quelled, and productive ideas were exchanged.
Read the full Golden Choice report here.
Read the Commonwealth Brief here.
Read the JAMA Health Forum article here.
- Public Option Health Plan For California Could Save Millions
“Two emeritus professors at UC Berkeley School of Public Health have proposed a California public option health insurance plan called Golden Choice that could save more than $243 million in its first year and lower insurance premiums throughout the state marketplace.”
Read the full article here.
- UC Berkeley Researchers Featured in State of Reform
“Our proposal and our plan here is unique in the sense that it builds on the foundation of the delegated model in California, where providers accept full or partial risk, and they are paid to do that—they accept a capitation rate, which is generally risk adjusted,” Scheffler said.
Read the full article here.
- Comments of Health Law and Policy Researchers on Non-Compete Clause Rulemaking as Applied to Physicians
“We are health law and antitrust, health services research, and health economics researchers specializing in health law and policy issues. We have studied private equity and other corporate investment in physician practices and examined the effects on patient care, workforce composition, market consolidation, and costs. Our comments focus on the application of the Non-Compete Rule to physicians and other health care professionals.”
Read about it here.
- Ola Abdelhadi & Richard Scheffler Among 2022 NIHCM Research Program Grantees
The NIHCM Foundation is a nonprofit, nonpartisan organization dedicated to transforming health care through evidence and collaboration. Read more about the work and the full press release here.
Petris Director Joins the Better Healthcare Policy Group
