The New Politics of US Health Care Prices: Institutional Reconfiguration and the Emergence of All-Payer Claims Databases
Prices are a significant driver of health care cost in the United States. Existing research on the politics of health system reform has emphasized the limited nature of policy entrepreneurs’ efforts at solving the problem of rising prices through direct regulation at the state level. Yet this litera...
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| Veröffentlicht in: | Journal of health politics, policy and law policy and law, 2017-02, Vol.42 (1), p.5-52 |
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| container_title | Journal of health politics, policy and law |
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| creator | Rocco, Philip Kelly, Andrew S. Béland, Daniel Kinane, Michael |
| description | Prices are a significant driver of health care cost in the United States. Existing research on the politics of health system reform has emphasized the limited nature of policy entrepreneurs’ efforts at solving the problem of rising prices through direct regulation at the state level. Yet this literature fails to account for how change agents in the states gradually reconfigured the politics of prices, forging new, transparency-based policy instruments called all-payer claims databases (APCDs), which are designed to empower consumers, purchasers, and states to make informed market and policy choices. Drawing on pragmatist institutional theory, this article shows how APCDs emerged as the dominant model for reforming health care prices. While APCD advocates faced significant institutional barriers to policy change, we show how they reconfigured existing ideas, tactical repertoires, and legal-technical infrastructures to develop a politically and technologically robust reform. Our analysis has important implications for theories of how change agents overcome structural barriers to health reform. |
| doi_str_mv | 10.1215/03616878-3702746 |
| format | Article |
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Existing research on the politics of health system reform has emphasized the limited nature of policy entrepreneurs’ efforts at solving the problem of rising prices through direct regulation at the state level. Yet this literature fails to account for how change agents in the states gradually reconfigured the politics of prices, forging new, transparency-based policy instruments called all-payer claims databases (APCDs), which are designed to empower consumers, purchasers, and states to make informed market and policy choices. Drawing on pragmatist institutional theory, this article shows how APCDs emerged as the dominant model for reforming health care prices. While APCD advocates faced significant institutional barriers to policy change, we show how they reconfigured existing ideas, tactical repertoires, and legal-technical infrastructures to develop a politically and technologically robust reform. 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Existing research on the politics of health system reform has emphasized the limited nature of policy entrepreneurs’ efforts at solving the problem of rising prices through direct regulation at the state level. Yet this literature fails to account for how change agents in the states gradually reconfigured the politics of prices, forging new, transparency-based policy instruments called all-payer claims databases (APCDs), which are designed to empower consumers, purchasers, and states to make informed market and policy choices. Drawing on pragmatist institutional theory, this article shows how APCDs emerged as the dominant model for reforming health care prices. While APCD advocates faced significant institutional barriers to policy change, we show how they reconfigured existing ideas, tactical repertoires, and legal-technical infrastructures to develop a politically and technologically robust reform. 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| source | MEDLINE; Political Science Complete; PAIS Index; Worldwide Political Science Abstracts; Business Source Complete; Sociological Abstracts |
| subjects | Barriers Change agents Constraints Consumers Databases as Topic Disclosure of information Entrepreneurship Forging Health care Health care expenditures Health care policy Health Care Reform - economics Health Care Reform - organization & administration Health Facilities Health problems Humans Medical decision making Medicine and Health Policy making Political Science Politics Pragmatism Price increases Pricing policies Public Health and Health Policy Public Policy Reconfiguration Reforming Reforms Regulation Studies Transparency United States |
| title | The New Politics of US Health Care Prices: Institutional Reconfiguration and the Emergence of All-Payer Claims Databases |
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