340B Court Cases

The Public Health Service Act (PHSA) in 1992, created a program to allow hospitals providing care for underserved communities to be able to access discounted drugs. The program–known as the 340B Drug Pricing Program, has been described as follows: …[The] law requires pharmaceutical manufacturers participating in the Medicaid program to enter into a second agreement…

Who pays more for hospital and physician services: commercial payers, Medicare or Medicaid? And how much more?

Many people might know that generally the answer is commercial health plans have the most generous reimbursement compared to government plans. However, a key question is how much more do they pay? Commercial vs. Medicare rates A January 2022 report by the Congressional Budget Office finds that commercial payers reimburse hospitals at 223% of Medicare…

Nurse employment and wage trends

Recent news articles have spilled much ink about the current nurse shortage. According to Pew, due to nursing shortages “Hospitals nationwide are canceling nonemergency surgeries, struggling to quickly find beds for patients and failing to meet the minimum nurse-patient ratios experts recommend.” Nursing wages are rising as well. The Baltimore Sun reports that the University…

Quality of Care at Teaching Hospitals

Medicare pays higher reimbursement to teaching hospitals through indirect medical education (IME) payments to hospitals that train a high share of residents. IME inflate standard reimbursements in an attempt to compensate hospitals for these additional costs. Medicare also pay hospitals directly for some cost of training residents through the graduate medical education (GME). A key…

Impact of Certificate of Need on Health

An interesting paper from Kevin Chiu in the Journal of Health Economics looks at the relationship between certificate of need laws and health outcomes: Certificate of need (CON) regulations requires that health care providers obtain state approval before offering a new service or expanding existing facilities. The purported goal of CON regulations is to reduce…

Few Americans research hospital prices

New regulation is making hospital prices available to patients. The Kaiser Family Foundation (KFF) reports: As of January 1 of this year, hospitals are required to post prices of common health services on their websites via consumer-friendly tools for patient use. Prior to implementation of this rule, hospitals were only required to publish their gross,…