Ginsburg maintained that there are a lot of forces pushing for consolidation, including reforms in provider payments. He said steps need to be taken to make markets more competitive despite consolidation, including revisiting the Federal Trade Commission's safe harbor policy to require a demonstration of patient benefit in a merger or acquisition.
Will CMS release more data?
Delbanco would like the Centers for Medicaid and Medicare Services to release more data and allow it to be used by qualified entities to analyze for quality and payment patterns. Dr. Colello noted that CMS is sitting on so much data and making it accessible will help improve the quality of care. He added that employers should have access to claims data.
Earlier this month, in addition to costs for certain inpatient procedures, CMS made public estimates for average charges for 30 types of hospital outpatient procedures.
Should Medicare have the ability to negotiate drug prices?
"It's completely logical," stated Dr. Colella. "If you're the biggest payer, you have market power and you should be able to negotiate to reduce drug costs."
Sen. Max Baucus (D-MT), committee chair, closed the hearing with a request for specific recommendations from both the witnesses and "anyone watching this hearing. It's an abomination that we pay about 60% more for healthcare in this country than the next most expensive country. Something's not quite right there. Market forces have a tough time in this area."