Objectives: To develop an effective legal mechanism to combat chargemaster abuses and to facilitate price transparency.Study Design: Applying legal doctrines to out-of-network (OON) billing disputes.Methods: We reviewed rudimentary contract law and examined the law's handling of contracts where...

Accountable care organizations (ACOs) were the cornerstone of the novel payment strategies for Medicare reform under the Affordable Care Act (ACA). The ACO initiative was intended as an experiment in health policy, and according to recent findings, the experiment so far has failed to produce...

By their nature, the recent antitrust cases scrutinizing the two proposed health insurance mega-mergers -- Anthem with Cigna and Aetna with Humana -- focused on narrow definitions of specific markets and the likely static impact on prices. But the antitrust proceedings omitted a broader...

Recent discussions in health reform circles have pinned great hopes on the prospect of innovation as the solution to the high-cost, inadequate-quality U.S. health system. But U.S. health care institutions - insurers, providers, and specialists - have ceded leadership in innovation to Indian...

The wave of new Accountable Care Organizations (ACOs), spurred by financial incentives in the Affordable Care Act, could become the latest chapter in the steady accumulation of market power by hospitals, health care systems, and physician groups. The main purpose behind forming many ACOs may not...

U.S. hospitals and physicians regularly charge uninsured patients and patients receiving care outside their health-plan networks far more what most health insurers pay and far more than their actual costs. Such practices have triggered over 100 lawsuits and prompted calls for pricing...