Center for Advancing Health Policy through Research

State Policies to Enhance Competition and Affordability

Many U.S. states are enacting their own efforts to enhance the accessibility, quality, fairness, and affordability of health care.

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These policies include:

  • surprise billing protections
  • health insurance exchange oversight
  • health price transparency tools
  • policies on competition and consolidation
  • price limits for medical services

However, the impact of these policy innovations and the specific design features that drive success or failure are not yet clear. CAHPR researchers are studying the effectiveness of various state policies on prices, spending, utilization, as well as on health care labor. These findings have the potential to provide guidance to other states considering similar approaches to regulate health care prices.

Hospital Payment Cap Simulator

The Hospital Payment Cap Simulator provides anyone from policymakers to researchers with insights into how much state employee plans across the US could save from hospital payment caps and the impact on commercial hospital operating margins. Read the instructions below to learn how to use the tool.

Click here to visit the Simulator

Recent News
Providence Business News

Study: Hospital payment caps could save millions for state employee health plans

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.
Healthcare Innovation

Hospital Payment Caps Could Safely Save Millions

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.
Milbank Memorial Fund

How Payment Caps Can Reduce Hospital Prices and Spending: Lessons from the Oregon State Employee Plan

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.