Health care is local, and so are laws impacting health care cost and quality.
If the health care system weren’t complicated enough, we also have 50 states, each with their own set of laws that govern the health care marketplace and impact the health care system’s likelihood of delivering high quality, affordable care. Just when you get excited to do something bold, like an employer contracting directly for health care services from an ACO, you might find out that local laws prohibit it. Before you go too far in your strategic planning, it’s a good idea to understand the legal environment.
In 2019, CPR and The Source on Healthcare Price and Competition at UC Hastings, with support from the Robert Wood Johnson Foundation, launched a Database of State Laws Impacting Costs and Quality in Healthcare. Searchable and free to use for anyone (no log in needed!), the Database covers laws that govern five areas:
- payment reform for health care providers,
- transparency of health care prices,
- health insurance benefit designs,
- provider network design, and
- competition among health care providers.
Using the database, CPR and The Source published an article in the Health Affairs blog on how state laws are addressing health care costs and quality. More recently, the two organizations produced a report highlighting trends on state laws impacting provider market power, along with a complete catalogue of the state laws in this space. We summarized the themes we identified on LinkedIn. We published an article in JAMA Health Forum on state legislative efforts to promote price transparency, complementing our updated Report Card on State Transparency Laws. Meanwhile, the Healthcare Value Hub used the database to help create the Healthcare Affordability State Policy Scorecard.
In January 2021, CPR and The Source published three blogs on Health Affairs covering the following topics:
- Supporting Health Care Competition In The Era Of COVID-19: Three Legislative Models For States
- State Policies To Make Health Care More Affordable During COVID-19 And Beyond
- Promoting Value In Health Care: Three Innovative Payment Models for States
Each blog expanded on insights drawn from the database by analyzing available research studies on the state policies of interest.
A database might sound like something that only law students and policy wonks care about. But most stakeholders would benefit from understanding the legal constraints and opportunities that state laws create when it comes to improving the functioning of the health care system. Now that you have a better understanding of the content in the Database, we encourage you to take a look. Which laws are in place in your state? Which laws are most likely to affect your business?
Let us know how the database helps you by writing us at connect@catalyze.org. If you’re looking for state policies in response to the coronavirus (COVID-19) pandemic, we recommend Kaiser Family Foundation’s State Data and Policy Actions to Address Coronavirus.
Photo by Kevin Ku on Unsplash.