Implementing Competitive Bidding in the Medicare Program: An Expressway to Solvency.

The Medicare program faces increasing budgetary pressures, with recent estimates suggesting that the Medicare Hospital Insurance Trust will be insolvent as soon as 2028. Simultaneously, the Medicare Advantage (MA) program, a managed competition model, continues to grow its market penetration as beneficiaries increasingly choose private plans over traditional fee for service (FFS) Medicare. With the relative cost of the 2 forms of Medicare a subject of debate, policy experts have proposed a variety of policy options to address the program's budgetary pressures and place it on a firmer fiscal footing.

Is there a labor shortage?

A panel discusses ongoing and prospective developments in the US labor market. Michael Horrigan points out that job losses in the COVID recession were heavily concentrated among women, minorities, and less-educated workers. In turn, these groups have shown less progress regaining jobs, and many have left the labor force.

Health insurance, medical debt, and financial well-being.

We study the financial protection provided by health insurance through two natural experiments-the Affordable Care Act's under 26 provision and Medicare eligibility. In both cases, the coverage expansion sharply reduces medical debt in collections for consumers within the affected ages but does not systematically improve credit outcomes not directly related to medical care. This is consistent with the infrequent repayment rate and lack of persistence on credit reports that we document for medical collections, which mute a key channel through which reductions in medical collections could directly affect the other financial outcomes studied here.

Politics and the distribution of federal funds: Evidence from federal legislation in response to COVID-19.

COVID-19 relief legislation offers a unique setting to study how political representation shapes the distribution of federal assistance to state and local governments. We provide evidence of a substantial small-state bias: an additional Senator or Representative per million residents predicts an additional 670 dollars in aid per capita across the four relief packages. Alignment with the Democratic party predicts increases in states' allocations through legislation designed after the January 2021 political transition.

Branded Price Variation in the United States Drug Market, 2010 to 2019.

The transaction price for branded drugs in the United States often varies widely by the eventual payer, a fact that can complicate research and policy discussions surrounding drug pricing. We combine publicly-available data on branded drug prices from a host of sources-prices paid by Medicare (Parts B and D), the Veterans Affairs Administration (VA), those included in the Federal Supply Schedule (FSS), invoice prices paid by pharmacies described in National Average Drug Acquisition Costs (NADAC), list prices, and payments ultimately received by drug makers-to illustrate how prices vary across the U.S.

The Impact of the COVID-19 Pandemic on Elective Inpatient Surgical Admissions: Evidence From Maryland.

Background: The COVID-19 pandemic led to large-scale cancellation and deferral of elective surgeries. We quantified volume declines, and subsequent recoveries, across all hospitals in Maryland.

Materials And Methods: Data on elective inpatient surgical volumes were assembled from the Maryland Health Service Cost Review Commission for years 2019-2020.

Hospital Revenue Under Maryland's Total Cost of Care Model During the COVID-19 Pandemic, March-July 2020.

This study compares revenue of Maryland hospitals in March-July 2020 vs historical trends and assesses whether rate increases for inpatient and outpatient services that were permitted to offset pandemic-related decines in revenues were associated with changes to state hospital revenue.

Health Costs And Financing: Challenges And Strategies For A New Administration.

It is likely that 2021 will be a dynamic year for US health care policy. There is pressing need and opportunity for health reform that helps achieve better access, affordability, and equity. In this commentary, which is part of the National Academy of Medicine's Vital Directions for Health and Health Care: Priorities for 2021 initiative, we draw on our collective backgrounds in health financing, delivery, and innovation to offer consensus-based policy recommendations focused on health costs and financing.

Economists tackle the challenges of a pandemic.

The COVID-19 pandemic radically and rapidly changed the world, including the world of business economists. Eight NABE members employed in a wide variety of fields discuss how their lives and work were transformed.

Abandoning List Prices In Medicaid Drug Reimbursement Did Not Affect Spending.

State fee-for-service Medicaid programs have traditionally based payments to pharmacies for drugs on a percentage of the drugs' list price. Because list prices have increased more quickly than the prices actually paid by pharmacies, estimating appropriate reimbursements has become challenging. In recent years most states have switched to models where payments were based instead on results from a survey of pharmacy invoices.

Opioid discontinuation as an institutional mandate: Questions and answers on why we wrote to the Centers for Disease Control and Prevention.

On March 6, 2019, a self-designated committee sent a public letter to the Centers for Disease Control and Prevention (CDC) urging the agency to address the widespread misapplication of its 2016 guideline on prescribing opioids. Three hundred and eighteen health care professionals, and three former Directors of the White House Office of National Drug Control Policy (Drug Czars) signed the letter, as did the parent organization for Substance Abuse Journal, the Association for Multidisciplinary Education and Research on Substance use and Addiction. The letter reflected concern about a wide range of initiatives and policies by payers, quality metric agencies, health care organizations, and other regulators enforced to strongly incentivize or mandate forced opioid dose reductions on long-term opioid recipients who were otherwise stable.

Improve Markets, Not Government Controls, for Real Health Reform.

Proposals to replace the existing mix of public and private health financing with a fully nationalized government system ("Medicare for All") fail to address fundamental problems of high cost, overutilization, and inefficiency. Those proposals are a reaction to the Affordable Care Act, which provided new insurance subsidies but did little to solve the cost problem. Stabilizing the individual insurance market is not the goal.