Drugmakers are experimenting with direct-to-consumer sales in response to Trump’s push for lower drug prices, aiming to bypass traditional middlemen like PBMs. While the strategy could reshape how patients access medications, experts warn its impact on affordability, safety, and equity remains uncertain.

Traditional Medicare plan holders have typically not had to wait for prior authorization before receiving medical treatment. CMS recently announced a new program to test prior authorization requirements for certain services in six states to root out fraud, waste and abuse. Jeffrey Marr highlights what’s needed to set up a well-functioning prior authorization system.

Another news article speaks on a study published in Health Affairs that reveals a sharp rise in urban hospitals reclassifying themselves as "rural" under Medicare rules, allowing them to access financial benefits intended for rural health providers. Researchers warn that this loophole could redirect billions in federal funds away from genuinely rural hospitals and urge policymakers to take corrective action.

Hundreds of large, urban hospitals have taken advantage of a 2016 policy change to classify themselves as both urban and rural, allowing them to access financial benefits meant for rural hospitals. Researchers warn that this loophole could divert billions in taxpayer funds away from actual rural communities and into already well-funded urban hospitals unless policymakers intervene.

This piece, authored by Hayden Rooke-Ley, argues that while the Trump administration’s One Big Beautiful Bill Act threatens to gut Medicaid funding by nearly $1 trillion over a decade, states still have powerful tools to protect coverage and even strengthen their healthcare systems. By capping inflated prices in the private insurance market and redirecting those savings to Medicaid—where every dollar is federally matched—states can blunt the impact of federal cuts, support vulnerable providers, and reduce systemic inequities.

The article investigates how major drugmakers like Pfizer and Eli Lilly are paying telehealth companies millions of dollars to connect patients to providers, raising concerns about potential conflicts of interest and violations of anti-kickback laws. While both companies deny influencing prescriptions, lawmakers and experts worry these partnerships may steer patients toward expensive branded drugs and allow pharma firms to collect detailed patient data.

This article talks about two commentaries by Hayden Rooke-Ley that argue that neoliberal, profit-driven models of U.S. healthcare—particularly privatized Medicare and value-based payment—have failed patients by prioritizing corporate interests over access and quality of care. He calls for a shift to a publicly governed, single-payer system that removes financial conflicts of interest and restores decision-making to non-commercial entities and caregivers.

This article covers a study in JAMA Health Forum finds that private equity-acquired gastroenterology practices significantly raised colonoscopy prices without any improvement in quality of care. The rise in costs was especially steep in highly consolidated markets, where prices surged by 6.7%. With no measurable gains in patient outcomes, the findings raise broader concerns about the impact of PE’s profit-driven model on healthcare affordability, transparency, and value.

This article argues that despite Massachusetts’ recent reforms after the collapse of Steward Health Care, a major loophole still allows private equity to control medical practices through shell companies and “friendly physician” arrangements. Drawing on the century-old corporate practice of medicine (CPOM) doctrine, the article calls for stronger legal restrictions like those recently passed in Oregon to protect patient care from financial interests.

This article reports on a study by Daniel R. Arnold, and colleagues who find that private equity-acquired gastroenterology practices significantly increase colonoscopy prices—by 4.5% more than independent practices—without improving care quality. Despite claims that consolidation boosts efficiency, the analysis showed no statistical difference in quality measures, raising concerns about affordability and access.

A bipartisan group of lawmakers has introduced legislation to stop Medicare Advantage insurers from collecting billions in federal payments for veterans who primarily receive care through the VA. Sparked by a Wall Street Journal investigation—supported by data from Brown University researchers—the bill aims to close a loophole that enabled an estimated $44 billion in excess payments from 2018 to 2021.

This article reports on a FTC study highlighting how roll-up acquisitions of physician practices—often led by private equity firms—can harm competition, raise prices, and reduce care quality. The study calls for increased scrutiny of serial acquisitions that fall below federal reporting thresholds, and experts say it could lead to stronger antitrust enforcement in healthcare markets.

This article discusses how financial pressures, staffing shortages, and management decisions at Wisconsin’s Group Health Cooperative have led to a unionization effort by primary care providers, reflecting broader national challenges facing independent primary care.

Several states are adopting hospital price caps to curb rising healthcare costs, citing limited success from other reforms. Supporters see savings, while hospitals warn of revenue loss and service cuts. See what CAHPR's Roslyn Murray, Ph.D. has to say.

Nominated by Arnold Ventures, Dr. Singh joined over 100 global fellows in Colorado in June 2025 to explore how market forces are reshaping health care at this year’s “Payoff: Investing in Health” conference by the Aspen Institute.

On Wednesday, the state House passed Senate Bill 951, the latest effort to expand Oregon’s prohibitions on corporate ownership in local care providers.

This news video features Dr. Andrew Ryan, Director of CAHPR, discussing his study on Rhode Island’s hospital affordability standards, which led to significant hospital price and premium reductions—saving $1,000 per fully insured member by 2022.

Professors Erin Fuse Brown and Yashaswini Singh warn that private equity’s focus on short-term returns is reshaping healthcare at the expense of patients and providers. From overburdened hospitals to ethical dilemmas in mental health care, their insights expose how profit-driven ownership can undermine clinical priorities and public trust.

This article reports on a study by CAHPR researchers that found that Rhode Island’s 2010 hospital price growth cap significantly reduced hospital prices and lowered premiums for fully insured health plans by $1,000 per member annually by 2022. However, the policy had limited impact on the self-insured market due to federal ERISA regulations, and the resulting hospital revenue losses have raised concerns about financial sustainability and care quality.

The article discusses how home health care workers in Rhode Island are fighting for better wages and working conditions through unionization, but their efforts are at risk due to proposed federal Medicaid cuts. David J. Meyers, a health economist at Brown University, warns that such cuts could have a “massive, qualitative impact on people’s lives” and ultimately increase health care spending as unmet needs at home lead to more hospitalizations and emergency visits.

The article discusses Dr. Ateev Mehrotra, chair of the Brown SPH Department of Health Services, Policy and Practice, and his concerns that ongoing temporary telehealth policies are stifling innovation and investment, as he urges permanent federal solutions to ensure long-term access and growth.

A Nevada bill aims to cap hospital fees for the Public Employees’ Benefits Program to reduce costs, drawing on Oregon's model, which researcher Roslyn Murray of Brown University studied and found led to significant savings without shifting costs to private insurers.

The article discusses the looming expiration of pandemic-era Medicare telehealth expansions and the ongoing policy debate over their extension, including new research by Ateev Mehrotra and Jared Perkins who suggest that lowering reimbursement rates for telehealth could make its permanent expansion more financially and politically viable.