Fuse Brown Delivers Keynote to National Academy of State Health Policy
In October, Erin C. Fuse Brown delivered the keynote address to open the 28th annual conference of the National Academy of State Health Policy. The conference is the annual gathering of health policymakers with more than 800 attendees from all 50 states, the federal government, the private sector, and health-related non-governmental organizations.
In her presentation, “The Double-Edged Sword of Health Care Integration: Consolidation and Cost Control,” she discussed how integration in health care has benefits in terms of quality and care coordination, but it also poses risks of market consolidation and rising prices. Fuse Brown highlighted the central role of states to control health care costs in their own markets and outlined five different policy approaches states can take to address vertical integration’s risks to competition.
“To address the rising prices from health care integration, there are many oversight models for states to choose from, but whatever they choose, states need to start with an ‘all-payer claims database’ because you need data to do this oversight,” Fuse Brown said. “It is important to me for my research to be policy-relevant, so it was an honor and fantastic opportunity to present to a room full of health policymakers from all over the country.”
The presentation was based on a project Fuse Brown is working on with Jaime S. King at University of California Hastings College of Law on vertical health care integration. Fuse Brown and King also presented their work in November at Harvard Law School and at Yale Law School’s conference on “The New Health Care Industry: Integration, Consolidation, Competition in the Wake of the Affordable Care Act.” During the fall, Fuse Brown also presented her research on vertical integration to health policy makers and Georgia legislators.
Fuse Brown concludes that if the health care cost curve is to be bent, the focus must be on both reducing overtreatment and constraining rising prices. The way to reap the benefits and manage the risks of health care integration is to encourage beneficial integration, but pair it with oversight on price and quality. “States have a variety of oversight models to choose from, and each has challenges, but states must do something if we are to bend the health care cost curve,” she said.
Fuse Brown’s vertical integration research is part of a larger research focus on legal issues relating to health care costs. She has looked at policies affecting hospital prices for health care services, consumer financial protections in health care, and on the imperfections and loss of competition in the health care market.
As with all her research, Fuse Brown seeks to affect real world policy and to help people. Accordingly, she seeks to publish her work outside the legal literature to reach physicians, administrators and policy makers. For example, in August, the American Medical Association (AMA) Journal of Ethics published her article, “IRS Rules Will Not Stop Unfair Hospital Billing and Collection Practices.” In September, the Annals of Internal Medicine published her article, “The Blind Spot in the Patient Protection and Affordable Care Act’s Cost-Control Policies,” examining the ACA’s policies to control health care costs.