The article discusses the proposed merger of Oregon Health & Science University (OHSU) and Legacy Health, which has drawn significant criticism for potentially violating federal antitrust standards. Advocates argue the merger would lead to excessive market consolidation in Oregon, controlling a majority of hospitals in key regions and potentially driving up healthcare costs without improving access or quality.

This article highlights a study led by Dr. Christopher Whaley that shows that while system affiliation helps improve CAHs’ financial stability, it often results in higher prices for patients.

This article explores the study by researchers from Johns Hopkins University and CAHPR at Brown University, which examines financial disparities between critical access hospitals (CAHs) and larger acute care hospitals from 2016 to 2022. The study highlights significant financial disparities, showing that system-affiliated critical access hospitals (CAHs) achieved higher operating margins than independent ones and highlights the need to balance financial sustainability with the risks of uneven care access and higher prices.

This news article covers the study led by CAHPR researchers who found that state employee health plans could save over $7 billion annually by capping hospital payments at 200% of Medicare rates. The findings suggest that such caps could ease budgetary pressures while minimizing disruptions to hospital operations.

This article dives into the controversial world of private equity in healthcare, where profit-driven strategies lead to higher patient costs and declining care quality. This article examines real examples, from staffing cuts to surprise billing, and explores how these changes threaten physician autonomy and the stability of U.S. healthcare.

This news article offers continued coverage on the impact of hospital payment caps and the potential for nationwide savings, based on the Health Affairs study led CAHPR researchers at the Brown University School of Public Health.

This news article provides continued coverage of the study by CAHPR researchers on hospital payment caps, and it's potential for saving billions without harming hospital finances.

The article examines California’s failed attempt to regulate private equity investments in healthcare through AB 3129, which proposed stricter transaction oversight and protections against corporate control of medical practices. It critiques the bill’s limited scope, exemptions, and political challenges while positioning it as a case study for future state-level reforms in addressing healthcare consolidation.

This article highlights a study by Christopher Whaley showing how hospitals have received billions in extra payments by documenting care at higher levels of complexity than expected. This practice, known as "upcoding," raises concerns about the incentives in current payment systems and their impact on rising healthcare costs.

The article written by CAHPR researchers, emphasizes the opportunity for Congress, in its final weeks of the 118th session, to advance healthcare affordability and transparency through the Lower Costs, More Transparency Act (LCMT) and the Health Care PRICE Transparency Act 2.0

UnitedHealth Group's insurance arm, UnitedHealthcare, pays its own Optum physician practices significantly higher rates than other providers in the same markets, driving up costs for consumers and employers while enriching itself. This practice highlights the conflicts of interest and anti-competitive effects of vertical integration in healthcare, raising calls for regulatory intervention.

Is Medicare Advantage improving healthcare efficiency or creating higher costs that favor insurers? Hayden Rooke-Ley explores its rapid expansion, questions about cost and care quality, and the challenges of implementing effective regulations.

This article outlines six key points about Oregon's regulatory review of the OHSU-Legacy merger. Hayden Rooke-Ley's critique of the OHSU-Legacy merger, emphasizing how OHSU's broad market definition may obscure significant anticompetitive risks, presenting a critical test for Oregon's Health Care Market Oversight program.

An increasing number of Medicare Advantage patients, especially those in their final year of life, are switching to traditional Medicare, leading to a significant cost shift from private insurers to taxpayers.

This article examines the Oregon Health Authority's comprehensive review of the proposed merger between OHSU and Legacy Health, highlighting key concerns about market concentration, potential cost increases, and the future of health care access and competition in the region.

This article examines lawsuits from Medicare Advantage insurers, who claim minor customer service issues threaten millions in bonuses, while experts like Brown University's David Meyers argue that these cases reveal deeper flaws in a rating system that overstates plan quality without accurately reflecting patient care.

This article explores a study led by Brown University researchers on the billions in potentially redundant payments Medicare Advantage plans receive for veterans primarily cared for by the VA, despite industry claims, like those from UnitedHealthcare, that these payments reflect actual costs.

The article exposes Ralph de la Torre's misuse of private equity-backed Steward Health for personal gain while highlighting the broader issue of private equity's damaging impact on healthcare, with legislative efforts for reform largely stymied by political and lobbying pressures.

This article explores how private equity firms have taken control of many U.S. emergency rooms, prioritizing profit by reducing physician hours, replacing doctors with less qualified staff, and inflating costs, resulting in compromised patient care and increased bills, despite regulatory efforts like the No Surprises Act.

As Medicare spending continues to rise, reaching 21 percent of total National Health Expenditures, policymakers are exploring site-neutral payment policies to mitigate costs without compromising care quality. This article examines the driving forces behind these policies, the bipartisan support they’ve garnered, and the challenges that lie ahead in implementing effective solutions.

This article explores the study done by Brown researchers on the imapct of Oregon's hospital payment cap and how other US states have an opportunity to implement similar control measures to achieve health savings.

CAHPR researchers examine the economic and healthcare implications of consolidation within the U.S. healthcare system while proposing legislative solutions aimed at curbing the adverse effects of consolidation.

The FTC's nationwide ban on non-compete agreements, originally set to take effect on September 4, 2024, is now entangled in legal battles that challenge the agency's authority. This article explores the ongoing debates, highlighting the loopholes in the current rule, and prescribes potential policy solutions.

A decade ago, CMS tried to rein in Medicare Advantage overbilling, only to withdraw amid industry pressure, now fueling a $2 billion fraud case against UnitedHealth. Newly released court documents expose the struggle to protect taxpayer dollars while navigating powerful industry pushback.

This article highlights a study published in JAMA Network Open that explores the impact of hospital-SNF (skilled nursing facility) integration on participation in alternative payment models (APMs), particularly focusing on the Bundled Payments for Care Improvement Advanced (BPCI-A) program. The findings reveal that while integration influences APM participation, the effects are complex, pointing to broader implications for healthcare systems.

The Medicare Physician Fee Schedule is a cornerstone of U.S. healthcare policy, directly influencing how services are priced and covered. This Health Affairs blog delves into a brief analysis of the CY25 Physician Fee Schedule Proposed Changes and what impact it could have moving forward.

Christopher Whaley, testified before Congress, highlighting the urgent need of health care price transparency and its role in combating high healthcare costs in the US and enhancing policy decision-making.

This issue brief provides key lessons for other states interested in hospital payment caps. These include setting caps above Medicare rates but below typical state plan prices to maintain provider participation, exempting small and rural hospitals to protect vulnerable facilities, and legislating payment caps to ensure long-term stability. Oregon’s approach offers valuable insights for states seeking to control health care spending while ensuring access to care.

Dr. Ashish K. Jha, dean of the Brown University School of Public Health, addressed the House Committee on Ways and Means on why the U.S. is seeing a decline in private medical practices and what we can do about it.

Healthcare consolidation is fueled by the need for pricing power and financial stability under value-based care, but experts warn this trend threatens competition and transparency, calling for stronger oversight and legislative action.

The PE firm, Welsh, Carson, Anderson & Stowe has been released from the ongoing case against U.S. Anesthesia Partners, for monopolization in Texas. What does this mean for PE firms and antitrust scrutiny?

Is private equity good AND bad? Listen to experts including Dr. Yashaswini Singh talk about private equity with a nuanced approach.

This article featuring Chris Whaley delves into whether the Valley Children's Hospital's actions align with its mission and the nonprofit ethos it claims to uphold.

State Treasurer Folwell's recent report with insights from Christopher Whaley unveils startling findings: North Carolina's 340B hospitals have been overcharging the state, shedding light on critical financial discrepancies in healthcare funding.

Erin Fuse Brown weighs in on the potential impact of the FTC's new rules against noncompete agreements, analyzing how this significant shift could empower healthcare workers and reshape the dynamics of the industry.

Amidst a silent surge of corporate takeovers in healthcare, Yashaswini Singh offers crucial insights into how these acquisitions are quietly transforming patient care and escalating costs, often beyond the public eye.

This article discusses Oregon's successful experiment in implementing price caps on hospital services, saving $107.5 million in two years, suggesting a viable solution for states battling soaring healthcare costs.

Under the CMS 2025 Medicare Advantage Advance Notice, CAHPR researchers emphasize the expected revenue increases and minor changes in risk adjustment practices; highlighting the impactful changes on the horizon and the critical reforms that still await attention.

Congress has a critical opportunity to advance healthcare price transparency, a move that could empower consumers and reduce costs across the system. This article explores the current state of healthcare price transparency and the critical role Congress plays in shaping a system that prioritizes clarity and fairness for all Americans.

Health care price transparency has seen growing support from policy makers and the US public alike. This article delves into the measures Congress has implemented to enhance transparency around health care costs and explores avenues for enhancing existing laws.

Rev Cycle Management, an information avenue for revenue cycle management writes on the Health Affairs study led by Brown researchers on the impact of hospital payment caps in Oregon and the health savings achieved for the state.

Oregon bill, HB 4130, aims to impose some of the strictest limits on corporate ownership of primary care and specialty clinics, targeting the influence of large companies and private equity firms.

This article looks at how private equity firms are increasingly employing "straw doctors" to circumvent restrictions on corporate ownership of medical practices -- threatening the quality of patient care and the integrity of the medical profession.

Ashish Jha casts a critical eye on the influence of private equity in healthcare, illuminating how these acquisitions not only escalate costs but also fundamentally reshape the quality and accessibility of medical care.

Read this NPR article or listen to the All Things Considered NPR broadcast featuring Dr. David Meyers where he talks about the difficulties a beneficiary can face when enrolled in Medicare Advantage.

Associate Professor of Health Services, Policy & Practice, Dr. Chris Whaley's 2023 publication along with other colleagues "What’s Behind Losses At Large Nonprofit Health Systems? " gets recognized as one of the top ten most read Health Affairs Forefront articles in 2023.

Yashaswini Singh and Christopher Whaley comment on the escalating presence of private equity in healthcare, exploring the compelling reasons doctors are selling their practices and the profound ripple effects this trend casts across the health care landscape.

Payer-led consolidation is understudied but a growing trend. Read Dr. Yashaswini Singh's thoughts on the corporization of healthcare.

Dr. Yashaswini Singh comments on the newly released health policy efforts by the Biden Administration on lowering drug prices and improving ownership transparency

Brown and Lifespan aim to strengthen their partnership in 2024. Read here to learn more about this potential partnership.