Health Care Affordability

The Tennessee legislature recently passed a bill that could make it the first state to request a Medicaid block grant. Under a block grant, Tennessee would receive a fixed annual sum from the federal government for its Medicaid program rather than open-ended federal dollars. But John Kitzhaber, MD, former governor of Oregon, and Bruce Goldberg, MD, former director of the Office for Oregon Health Policy and Research, say that this approach does nothing to reduce the cost of care and hurts Medicaid recipients. More

New research published by the RAND Corporation earlier this month compares hospital prices paid by private health plans with Medicare prices in 25 states. These new data shed light on hospital prices and point to some actions that states could take to help manage costs. More

Oregon has been a leader in targeting the growth in overall health care costs. In 2012, the state adopted a unique approach to growth limits for the… More

Rhode Island has a history of taking the lead when it comes to health care spending. Beginning in 2010, the state instituted health care… More

A certificate of public advantage (COPA) is a tool used by states to permit and oversee hospital mergers that create monopoly powers. A few months ago, we published a paper about the use of a COPA in Tennessee and Virginia. But what happens when a COPA is repealed? This issue brief looks at the COPA law in North Carolina that was enacted in 1993 and repealed in 2015. It provides a cautionary tale for other states considering COPAs. More

How are states responding to the growing trend of hospital system mergers? Some states have responded by issuing certificates of public advantage (COPAs), a legal mechanism through which they can approve mergers that reduce or eliminate competition in return for commitments to make public benefit investments and control health care cost growth. In effect, a COPA creates a state-monitored monopoly—or a public utility model of health care delivery. This report describes the experience of Tennessee and Virginia. More

“You can’t manage what you can’t measure.”  – Peter Drucker.  States face growing challenges to manage and measure health care costs. By… More