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
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).
The Petris Center study, “The Distribution of Provider Relief Payments Among California Health Systems” was cited in The New York Times on July 10, 2020. The analysis estimated that a 24% reduction in net patient revenue was offset by direct CARES Act grants and varied widely by hospital. Hospitals with a larger share of net patient revenue from private insurers and hospitals residing in highly concentrated hospital markets received larger payments per adjusted patient day.
On June 25, 2020, a Petris Center study titled “What are the Health Care Costs of COVID-19 in California?: State and County Estimates” was cited in the San Francisco Chronicle. The study estimates the total cost of COVID-19 at a 5% prevalence in the state at $2.4 billion. The article focuses on the high costs in the Bay Area due to higher commercial prices in this part of the state.
On April 17, 2020, Health Affairs Blog published “The Proposed Vertical Merger Guidelines And Health Care: Little Guidance And Dubious Economics,” a piece written by Thomas Greaney, JD,a visiting professor of law at UC Hastings College of Law in San Francisco and distinguished senior fellow with the UC Hastings/UCSF Consortium on Law, Science and Health Policy, and Richard Scheffler, PhD. The blog post details the lack of scrutiny placed on hospital acquisitions of physician organizations, despite the increasing rate this practice. Greaney and Scheffler assess the newly proposed Vertical Merger Guidelines created by the FTC, including where they may fall short and how they could be improved.
To read a pdf version of the Health Affairs Blog, click here.
To read a web version of the Health Affairs Blog, click here.
As part of the Labor Center’s blog series “Rising Health Care Costs in California: A Worker Issue,” Petris Center research was spotlighted in the eight blog post titled, “High Health Care Prices are the Primary Driver of California Workers’ Health Care Cost Problems.” The blog post referred to “The Sky’s the Limit: Health Care Prices and Market Consolidation in California,” a Petris Center study from 2019 that found increasing inpatient and outpatient prices in the state that have grown steadily from 2013 to 2017. Additionally, the report found higher prices in Northern California, reflecting the growing consolidation in Northern California.
On November 21, 2019, The Economist published an article titled “Donald Trump wants hospitals to be more upfront about prices,” referenced a study conducted by Brent Fulton as part of the Petris Center. Fulton found that 90% of American hospital markets were highly concentrated. Additionally, the percent of highly concentrated primary-care physician markets has nearly doubled since 2010, growing from 20% to over 40% in just eight years.
To read the full article, click here
To read the full report, click here
On Thursday, October 3rd, a Petris Center report showing increasing hospital and physician consolidation was included in an article centered on the Sutter Health trial in California. Professor Scheffler was quoted, saying that physician group acquisitions largely go unnoticed despite contributed to an already growing hospital consolidation and market power in the state.
To read the full article, click here.