Findings from HCFO-Funded Work Cited in Health Affairs Blog on Health Care Integration

A recent Health Affairs [1] blog post discussed states’ role in overseeing vertical health care integration. The authors note that while integration may reduce unnecessary use of services, it also risks further consolidation and price increases. As evidence to the latter, they reference findings [2] from a HCFO-funded study [3] by J. Michael McWilliams, M.D., Ph.D., Harvard Medical School, and colleagues that suggest that vertical integration may drive up costs without counterbalancing reductions in utilization. The blog post also discussed models for state oversight that could manage the potential downsides of vertical integration, including insurance rate review authority. They cite findings from a HCFO-funded study [4] by Richard M. Scheffler, Ph.D., University of California, Berkeley, and colleagues that suggest that states’ rate review authority, specifically prior approval authority and loss ratio requirements, can constrain health insurance premium increases.