"New state laws tackle the burden of medical debt and the corporate take-over of medicine."

by Kimberly Marselas

Meaningful opportunities to reduce U.S. health-care costs already exist but are often overshadowed by the focus on more politically prominent proposals.

Interview by Rob Lott

By Mario Aguilar

The article explains how growing consolidation among insurers, hospitals, and physician groups is driving higher prices and fewer choices for patients, while current antitrust tools struggle to keep up with these increasingly complex mergers.

While Medicare Advantage offers many advantages, it also has drawbacks that should be considered

Researchers found UnitedHealthcare paid 17% more to Optum than to other providers.

Researchers said the results suggest UnitedHealth may be sidestepping government rules meant to keep a lid on exorbitant payer profits.

The trend toward investor ownership is part of a broader national shift in health-care consolidation, said Hayden Rooke-Ley, a senior fellow at Brown University’s School of Public Health. Over the last decade, large non-hospital retailers such as Amazon and Walgreens, along with insurance conglomerates, have restructured to own or manage medical practices, drug distributors and wholesalers.

This article quotes Brown University researchers Chris Whaley and Roslyn Murray from the CAHPR, who explain that wide hospital price differences across Rhode Island stem less from care quality and more from market consolidation. Whaley noted that “there’s really not a strong relationship between price and quality,” while Murray pointed to “empire-building tactics” and consolidation that give large health systems leverage to raise prices and obscure transparency

On October 6, 2025, California Governor Gavin Newsom signed SB 351, aimed at limiting the involvement of private equity groups and hedge funds in health care practices.

This article discusses a Brown University study showing that commercial insurers pay nearly $1,500 more per procedure at hospital outpatient departments than at ambulatory surgical centers. The findings highlight large price variations across insurers and suggest opportunities for cost savings through selective contracting or site-neutral payment reforms.

Hospitals are discouraging infection testing to avoid Medicare penalties, a practice clinicians say jeopardizes patient safety and skews public reporting. As Brown University’s Andrew Ryan put it, “Basically, the measures are just really, really bad … this is honestly the worst” pay-for-performance program, underscoring deep flaws in how infection penalties are designed and enforced.

UnitedHealth’s Medicare Advantage program has come under scrutiny for allegedly exploiting diagnostic “upcoding” practices that drive billions in excess federal payments. Brown University researchers have launched Medicoding.org, a public tool that tracks how diagnostic coding in Medicare Advantage inflates payments to insurers. Health economist David Meyers explains that while some coding reflects real patient needs, much of the increase stems from insurers “gaming the system,” making beneficiaries appear sicker than they are

Republican lawmakers pressed for stricter oversight of nonprofit hospitals at a House hearing, arguing that many exploit tax exemptions while providing limited charity care. Witnesses, including Brown University’s Christopher Whaley, highlighted that current reporting structures obscure hospital-level community benefit, and urged stronger, more transparent requirements to ensure accountability.

In testimony before Congress, Brown University researcher Christopher Whaley revealed that many nonprofit hospitals reap massive financial benefits yet spend far less on community health than their tax exemptions are worth. With bipartisan concern mounting, Whaley urged reforms to ensure tax breaks translate into affordable, high-quality care for patients — not executive perks or stadium sponsorships.

This article reports on a Health Affairs study led by Brown University researchers analyzed over a decade of private equity acquisitions in opioid treatment programs across 43 states. The findings show that despite rapid growth in private equity ownership, there were no measurable improvements in methadone access, treatment expansion, or opioid-related mortality

This article talks about a Health Affairs study led by researchers at CAHPR, University of Pittsburgh and the RAND Corporation on the current PE ownership of opioid treatment programs in the US. Despite acquiring large shares of the market, PE firms are not expanding access to methadone—leaving the treatment gap largely unchanged.

A new Health Affairs study reveals that hundreds of urban hospitals have secured “Medicare administratively rural” status—unlocking benefits meant for rural communities. While CMS prepares to roll out its $50 billion Rural Health Transformation Program, the findings raise concerns about loopholes, misaligned incentives, and whether subsidizing facilities truly improves access for rural patients.

In the first half of 2025, states enacted numerous laws to strengthen their health care markets. These new laws address several recurring policy issues affecting states across the country, including skyrocketing health care costs, increased consolidation in the healthcare sector, and the heightened penetration of private equity in health care systems.

The proposed sale of two safety net hospitals — from private equity-backed Prospect Medical Holdings to the nonprofit Centurion Foundation — has been closely watched across the state. The Attorney General's updated terms for the sale reflect growing concern over the role of private equity in Rhode Island’s health care system.

A large number of nonprofit hospitals located in urban cities are exploiting a Medicare definition that allows them to be considered both “urban” and “rural” simultaneously, letting them tap generous benefits and reimbursement models specifically intended for rural communities.