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Healthcare Competition

All articles tagged with #healthcare competition

When a hospital becomes your insurer: early clues from the payvider wave
health-care-policy2 hours ago

When a hospital becomes your insurer: early clues from the payvider wave

Hospitals that also own insurance plans (the payvider model) are becoming more common, potentially improving care coordination but raising concerns about incentives to game risk-adjustment payments and inflate costs. Early data suggest affiliated Medicare Advantage plans can have higher premiums and prices than unaffiliated ones, though explanations vary and many questions remain about overall costs, care quality, and competition. More research is needed to understand the trade-offs.

Policy-Driven Hospital Consolidation Fuels Price Inflation, Report Warns
health-policy3 months ago

Policy-Driven Hospital Consolidation Fuels Price Inflation, Report Warns

A policy-focused paper argues U.S. hospitals have become expensive largely because government policies reward consolidation and shield providers from competition—via CON laws, physician-owned hospital barriers, subsidies, and complex payment schemes—leading to prices rising faster than inflation even as outpatient care grows. Hospitals remain profitable, supported by Medicare/Medicaid and investment income, while price transparency is limited and costs are driven up by subsidies and consolidation. The report calls for site-neutral Medicare/Medicaid payments, tighter subsidy oversight, repeal of anticompetitive rules, targeted charity-care standards, and reform of hospital subsidies to reward efficiency and true need, aiming to restore competition and reduce costs for patients and taxpayers.