Combinations of State-Based Health Care Policies to Constrain Commercial Prices and Rebalance Market Power

It’s become painfully apparent that health care doesn’t adhere to the laws of economics, and well-meaning market-based interventions (price transparency, consumer-driven health plans, innovative care delivery models, even provider payment reform) cannot exert enough pressure to right this capsized ship. With this degree of dysfunction, we need a more powerful force to referee the marketplace and level the playing field.

We need government intervention – specifically, state government intervention. 

States can tailor policy to the specific needs, conditions, and mores of their constituents; they can launch smaller-scale experiments that would be impractical or impossible to pass nationally; and they can use their own purchasing power to command lower prices, new payment models, and higher standards of care.

A single policy won’t suffice

Plenty of entities within the health care ecosystem that profit from the status quo will do all they can to find loopholes and workarounds to preserve it.  Also, most policy interventions require data infrastructure, oversight and enforcement.  Combinations or menus of policy interventions are necessary to erect infrastructure, close loopholes, and guard against externalities

Funded with generous support from Arnold Ventures, based on the wisdom of health care policy experts in academia and the private sector, CPR’s white paper profiles five scenario-based policy menus, designed to help state policymakers, advocacy organizations and other stakeholders navigate through the multitude of policy intervention options and identify those best suited to meet their unique circumstances.


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