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.
Listen to his event here. He touches upon public option, healthcare payment systems, the direction of telehealth, the impact of COVID-19, and prescription drug pricing.
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.
On Thursday, September 10, Professor Richard Scheffler served on an online panel discussing the topic: Antitrust Implications of Healthcare Provider Consolidation. Hosted by the California Lawyers Association, the webinar discussed antitrust issues that result from vertical integration, the impact of the COVID-19 pandemic on antitrust and economic analysis, and the ongoing Sutter case. The two other panelists were Laura Alexander (VP of Policy at the American Antitrust Institute) and Michelle Lowery (Partner at McDermott Will & Emery).
Healthy California for All Commission released a report, “An Environmental Analysis of Health Care Delivery, Coverage, and Financing in California” for California Governor Gavin Newsom, Senator Richard Pan, and California State Assemblymember Jim Wood. It examines the strengths and limitations of California’s current health care system, outlines potential designs to transition to unified financing, and describes health coverage expansion options.
In its analysis of provider consolidation, The Petris Center’s study “The Sky’s the Limit” is cited for trends of hospital market concentration. “A New Vision for California’s Healthcare system” is cited in discussing cost containment strategies, and “California Dreamin’: Integrating Health Care, Containing Costs, and Financing Universal” explores the role of integrated plans.
