Richard Scheffler hosts a presentation on the future of health policy under The Biden Administration. Join him on Friday (1/29) at 1:30 PST to learn more about proposed and potential direction of healthcare in the U.S.
Richard Scheffler and Surina Khurana analyze California Attorney General Xavier Becerra’s experience in health policy as The Senate confirms his nomination for Secretary of Health and Human Services. His record includes defense for the Affordable Care Act, litigation for Sutter Health’s antitrust practices, and persecution for pay-for-delay practices. For his new role in the government’s insurance programs and pays for prescription drugs, he is qualified and well prepared.
Richard Scheffler and Thomas Price examine The Biden Administration’s path for implementing public option and states’ successes in using “quasi-public options”. Given potential political difficulty in passing national legislation, they identify key states that may enact public option programs. Risk-based capitation may product higher quality outcomes as a payment model.
The FTC has issued 6 health insurance companies to provide claims data from 2015 through 2020 for a merger retrospective program. With the new mandate to disclose payer-negotiated rates, analysis may shed light on the effects of physician group and healthcare facility consolidation. In a public letter, Richard Scheffler and other economists commented on vertical merger guidelines.
Richard Scheffler has experience in studying how premiums and outpatient prices spiked as California health systems have incrementally acquired physician groups.
Link to article here.
Link to FTC request here.
Richard Scheffler and other experts in the health care system published “How the Biden Administration Can Make a Public Option Work” in Harvard Business Review. This article argues for the termed Better Care Plan in which Biden-Harris’s public option proposal operates under The Medicare Advantage model with capitated payments. Insurers participating in public option would be in competition when annually required to provide transparent and uniform cost, utilization, quality, and patient experience data to the public.
Richard Scheffler worked with colleagues to publish an article titled “Better Care Plan: A Public Option Choice” in Health Affairs on November 16, 2020. This recommends that the Biden-Harris health care proposal not be operated under fee-for-service like traditional Medicare.
If the public option were to be operated under pre-determined risk-adjusted capitation payments to teams of providers, health professionals would be incentivized to provide evidence-based care. In addition, payments made per-member-per-month would provide a predictable revenue stream–which is particularly important as COVID-19 threatens providers’ financial stability.
All authors: George C. Halvorson Stephen M. Shortell Laurence Kotlikoff Elizabeth Mitchell Richard M. Scheffler John Toussaint Peter A. Wadsworth Gail R. Wilensky
On October 22, 2020, Richard Scheffler was named an editorial advisory board member of The Milbank Quarterly, a quarterly peer-reviewed healthcare journal covering healthcare policy. Their publications connect empirical research to practical policymaking. The 38 scholars on the board collectively offer multidisciplinary insight into social, economic, political, historical, legal, and ethical aspects of health and healthcare policy.
The Petris Center article, “What Does Senator Kamala Harris’ Record As California’s Attorney General Tell Us About Her Health Policy?” was cited in The New York Times on October 6, 2020. This analysis delves into her history in health policy as attorney general in three areas: antitrust (especially mergers and consolidation), pharmaceuticals, and support of the Affordable Care Act (ACA). Richard Scheffler was quoted in The New York Times on Harris prioritizing health care as an attorney general.
By Richard M. Scheffler and Surina A. Khurana | Published October 1, 2020 in Health Affairs Blog | Link to Full Article
Health policy, like most public policy, is autoregressive: The past is usually the best predictor of the future. Democratic vice presidential nominee Kamala Harris’ position on national health policy issues is well known from presidential debates and public statements; less is known about what she actually did while serving as the attorney general for the state of California from 2010 to 2017. Most of her record in health policy as attorney general was in three areas: antitrust (especially mergers and consolidation), pharmaceuticals, and support of the Affordable Care Act (ACA). It is fair to say that she has been very active and effective in all three areas.
By Richard M. Scheffler and Taylor L. Wang | Published September 21, 2020 in Milbank Quarterly Opinion | Link to Full Article
There is little doubt that the cost of health care and universal coverage will be a major topic discussed at the upcoming presidential debates. A key debate will likely center on the Biden-Sanders Unity Task Force’s recommendations released earlier this year proposing a public option to compete against existing private insurers. The recommendations only outline a public option framework, so the details, both logistical and financial, will be key to moving forward. While recent articles have assessed the state-level public options in Washington State and New Mexico, we look internationally to Germany and Australia to evaluate how their health care systems have achieved universal coverage by delivering public health insurance. Both countries have a private component in the health insurance system: Germany allows individuals to purchase substitutive private insurance based on income, and Australia takes it a step further by creating incentives for all citizens to enroll in supplemental private insurance. We examine the framework of each system, how the public-private insurance dichotomy is organized, and some key takeaways for the United States.