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Electronic Health Record Market Consolidation and Implications for Cybersecurity

"Over the past decade, the electronic health record (EHR) market has become increasingly consolidated, with the majority of care delivery organizations now using one of two vendors ... This consolidation creates a 'single-point-of-failure' tail risk for cybersecurity ... Given that reversing consolidation is unlikely due to high EHR switching costs, it is critical that policymakers establish safeguards that ensure robust protections for patients' sensitive data.... Sustained investment in regulatory oversight and continued partnerships between policymakers, care delivery organizations, and EHR vendors are essential to contain the catastrophic risk involved from this ongoing market consolidation."

Understanding Health Care Price Variation: Evidence from Transparency-In-Coverage Data

"[The authors] measure health care prices in three ways ... Variation is large ... Pricing does not appear uniform; there is just 22% correlation between an insurer's inpatient price and outpatient facility price. And there is little difference in ordering of high price states depending on alternative measures, such as relative to Medicare. Results suggest greater consideration of policies to address high and highly variable prices for U.S. health care."

Ten Health Policy Challenges for the Next 10 Years

"Each of the ten assertions describes the challenges and steps that can be taken to address those challenges. [The authors] focus on issues that are traditionally studied by health services researchers such as cost, access, and quality, but then examine emerging and intersectional topics: equity, income, and justice; technology, pharmaceuticals, markets, and innovation; population health; and global health."

Telehealth Use During the Early COVID-19 Public Health Emergency and Subsequent Health Care Costs and Utilization

"[U]sing telehealth during the stay-at-home order period was associated with a reduction in total medical costs (by -$1814 per person), number of emergency department visits (by -88.6 per 1,000 persons), and inpatient admissions (by -32.4 per 1,000 persons). Telehealth use increased per-person per-year pharmacy prescription claims (by 0.514) and average number of days' drug supply (by.773 days)."

How Policymakers Innovate Around Behavioral Health: Adoption of the New Mexico 'No Behavioral Health Cost-Sharing' Law

"Beginning in 2022, New Mexico became the first state to eliminate cost-sharing for MH/SUD treatment in private insurance plans subject to state regulation.... [T]his study recounts the law's passage and intended impact."

High Prevalence of Ghost Rates in Transparency in Coverage Data

"A major challenge with the Transparency in Coverage (TiC) data ... is that many rates relate to providers and groups that do not provide those services.... These negotiated rates -- known as ghost rates -- undermine the goals of transparency data ... Across a combination of all 61 insurers, 91.8% of all the negotiated rates were ghost rates.... To maximize the potential of the TiC data, CMS 8 should require payers to include volume information, allowing users to quickly identify ghost rates."

Medicare Part D Insulin Coverage: Formulary Strategies Amid Policy Headwinds

"Using Part D formulary files from 2020 -- 2025 [the authors] examined plan insulin coverage separately for Medicare Advantage Prescription Drug Plans and stand-alone Prescription Drug Plans. [They] found that plans are moving insulins to a single tier but not broadly changing their utilization management tool strategies.... This study demonstrates strategic adjustments that insurers may be making in response to policy changes; ongoing study will be needed to monitor access to and spending on insulin in Medicare as the market and policy context continue to evolve."

Why Does the Cost of Employer Sponsored Coverage Keep Rising?

"Over the past 25 years, the gap between the increase in health insurance costs and workers' wages has significantly expanded.... [T]he hospital price index rose steadily between 2006 and 2023, faster than insurance premiums or professional services.... [H]ospitals (for-profit and non-profit) have consistently maintained higher profit margins than insurance companies. As health insurance costs continue to weigh heavily on working Americans, [this] analysis suggests that high hospital prices drive insurance premiums."

No Surprises Act Independent Dispute Resolution Outcomes for Emergency Services

"[The authors] analyzed public IDR data from 2023 for the most common disputed professional service: evaluation and management of a moderate to severe emergency medicine visit. Providers won 86% of the cases ... Private equity-backed providers won more often and higher monetary awards than other providers. The mean QPA was 2.4 times Medicare payments. Disputes were dominated by a small group of health plans and providers[.]"

Insurance Acceptance and Cash Pay Rates for Psychotherapy in the U.S.

"Taken together, low insurance acceptance across a broad swath of mental health provider types means that access to care is disproportionately reliant on patients' ability to afford out-of-pocket payments -- even when covered by insurance."