State employee health plan premiums and out of pocket costs are rising, affecting the state’s budget, as well as its employees’ overall health costs. Administering these health plans with diverse enrollees can be challenging, but also provides an opportunity to leverage the states buying power to find efficiencies and reduce overall costs. NASHP is working closely with State Employee Health Plans to explore and develop strategies aimed at improving the management of their plans to reduce costs.
Rampant consolidation in nearly every state has created dominant health care systems that can use anticompetitive contracting practices to charge supracompetitive prices, especially to commercial insurance plans.
https://www.nashp.org/wp-content/uploads/2018/05/hospital-complex-shutterstock-5_3_2018.jpg31544200Melanie Felicianohttps://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.pngMelanie Feliciano2021-04-12 15:49:522021-04-13 16:23:14A Tool for States to Address Health Care Consolidation: Prohibiting Anticompetitive Health Plan Contracts
https://www.nashp.org/wp-content/uploads/2018/05/hospital-complex-shutterstock-5_3_2018.jpg31544200NASHP Staffhttps://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.pngNASHP Staff2021-04-09 11:00:562021-04-12 20:01:07State Legislative Action to Lower Health System Costs
A new, independent analysis of the Montana state employee health plan’s transition to reference-based pricing – which limits hospital prices to a multiple of what Medicare pays – found significant savings for the state in the two years after its implementation. Further, there is no evidence that utilization artificially increased as a result of the new payment […]
https://www.nashp.org/wp-content/uploads/2018/05/hospital-complex-shutterstock-5_3_2018.jpg31544200Melanie Felicianohttps://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.pngMelanie Feliciano2021-04-05 16:54:482021-04-06 14:40:31Independent Analysis Finds Montana Has Saved Millions by Moving Hospital Rate Negotiations to Reference-Based Pricing
https://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.png00NASHP Staffhttps://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.pngNASHP Staff2021-04-05 16:53:072021-04-06 14:26:45Independent Analysis: Estimating the Impact of Reference-Based Hospital Pricing on the Montana State Employee Plan
Surprised that the national average rate that employer-sponsored health plans pay hospitals is 2.5-times higher than Medicare’s reimbursement rate? Or that there is actually no relationship between the volume of publicly covered patients a hospital serves to the prices it charges commercially-insured patients? This price transparency is important as states and employers work to rein […]
Facility fees – designed originally to compensate hospitals for “stand-by” capacity required for emergency departments and inpatient services – are increasingly added to bills for diagnostic testing and other routine services and are raising health care costs. One state employee health plan’s claims show that facility fees charged for COVID-19 testing conducted in outpatient hospital […]
https://www.nashp.org/wp-content/uploads/2018/05/hospital-complex-shutterstock-5_3_2018.jpg31544200Melanie Felicianohttps://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.pngMelanie Feliciano2020-08-24 18:30:572020-08-25 15:00:56Combat Rising Health Care Costs by Limiting Facility Fees with New NASHP Model Law
Model Act Summary: This model legislation prohibits site-specific facility fees for services rendered at physician practices and clinics located more than 250 yards from a hospital campus. It also prohibits all service-specific facility fees for typical outpatient services that are billed using evaluation and management codes, even if those services are provided on a hospital […]
https://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.png00NASHP Staffhttps://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.pngNASHP Staff2020-08-24 15:11:462020-08-25 13:36:20NASHP Model State Legislation to Prohibit Unwarranted Facility Fees
The Centers for Medicare & Medicaid Services (CMS) has proposed a new rule with provisions designed to advance value-based purchasing (VBP) arrangements with drug manufacturers. Comments about the proposal are due July 20, 2020.
https://www.nashp.org/wp-content/uploads/2018/10/st-rx-admin-action-image-shutterstock_10_15_2018.jpg37445616Melanie Felicianohttps://www.nashp.org/wp-content/uploads/2019/06/NASHP-Logo.pngMelanie Feliciano2020-06-22 20:07:202020-06-23 12:49:46CMS Proposes Rule to Support Value-Based Purchasing for Drugs
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