About: Katie Gudiksen, Senior Health Policy Researcher
Katie Gudiksen, Ph.D., is the Executive Editor for The Source on Healthcare Price and Competition. Dr. Gudiksen is an expert in healthcare reform and the drivers of healthcare costs, with a special interest in market consolidation and state policies to address market power. She has helped draft model legislation to improve state merger review processes and to prohibit anticompetitive terms in contracts between insurers and health systems. Her current work focuses on evaluating the options states have to restrict excessive provider prices, including cost-growth benchmarks and state public options.Rate Setting for Health Services: A “Radical” Proposal or A Proven Way to Control Healthcare Costs?
Katie Gudiksen, Senior Health Policy Researcher April 27, 2018
On February 16, 2018, California State Assembly Member Ash Kalra introduced Assembly Bill 3087 – The Health Care Price Relief Act, which calls for a commission to set uniform rates for medical providers, including hospitals and physicians, for the private-insurance market. The bill sets the floor for payment at the Medicare rate and places the onus on providers to apply for adjustments to the base amount.[1] AB 3087 advanced out of committee on April 25, 2018, but faces fierce opposition from doctors and hospitals, among other groups.[2] In this post, The Source …
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Are APCDs the Solution to Price Transparency in Healthcare?
Katie Gudiksen, Senior Health Policy Researcher April 16, 2018
As health care costs continue to rise, voters have identified “health care” as the top issue for the 2018 elections. In response, in March 2018, a group of bipartisan Senators asked thirty stakeholders for feedback as they develop legislation to increase price transparency in the healthcare market in order to increase competition and drive down prices for healthcare services. A lack of price transparency for health care prevents patients from shopping for medical care the way they can for other services, thereby driving up costs. There are no consistent or …
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Single-Payer vs. Public Option: Can Either System Address Rising Health Care Prices?
Katie Gudiksen, Senior Health Policy Researcher March 29, 2018
In February 2018, the Centers for Medicare and Medicaid Services (CMS) released data that National Health Expenditures accounted for 17.9% of Gross Domestic Product (GPD) and exceeded $10,300 per person. Even more alarming, CMS predicts that health expenditures will increase at an average rate of 5.5%, faster than inflation or increase in GPD, so that by 2026, health care will cost almost 20% of GDP. As a result of escalating costs of health care and increasing cost-sharing and co-pays for individual patients, those on the left of the political spectrum …
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A Drug Rebate’s Tale: How a Class Action Lawsuit in the 90s Shaped Drug Pricing
Katie Gudiksen, Senior Health Policy Researcher February 24, 2018
Do you ever wonder why it is so hard to know what a prescription drug actually costs? How did we get a system where prices are obscured, even from insurers, and contracts prevent pharmacists from telling patients when they are paying more than they should be? How did the pharmaceutical industry wind up in a world of rebates and complicated contracts with pharmacy benefit managers that result in a lack of transparency for everyone? Setting the Stage: The Lawsuits that Laid the Groundwork To understand how we got …
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Source Shorts: White House Releases Report on Drug Pricing
Katie Gudiksen, Senior Health Policy Researcher February 13, 2018
On Friday, February 9, 2018, the White House released a report from the Council of Economic Advisers (CEA) entitled “Reforming Biopharmaceutical Pricing at Home and Abroad”. The report identifies two seemingly conflicting goals of the current administration: 1) reducing domestic drug prices and 2) spurring economic investment in medical innovation. These goals appear to conflict since lower prices would likely mean lower profits for drug companies, resulting in lower investment in research and development. The report also accuses foreign governments of eroding global returns for investment in pharmaceuticals, stating: “nations …
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Do Drugs That Treat the Same Indication Compete with Each Other?
Katie Gudiksen, Senior Health Policy Researcher January 23, 2018
High drug prices and the rate at which they are increasing worry most Americans. A quarter of Americans report difficulties affording their medications. Recognizing the need to control spending on prescription drugs, the Federal Trade Commission (FTC) held a workshop on November 8, 2017 entitled “Understanding Competition in Prescription Drug Markets: Entry and Supply Chain Dynamics.” At the workshop, Acting FTC Chairman Maureen K. Ohlhausen asserted that “competition is key to containing prescription drug costs”[1] and Commissioner of the Food and Drug Administration (FDA) Dr. Scott Gottlieb said that …
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Crossing the Political Divide: Senate HELP Committee Hearings on Drug Prices
Katie Gudiksen, Senior Health Policy Researcher December 22, 2017
On December 12, 2017, the Senate Committee on Health, Education, Labor, and Pensions (HELP) held a bipartisan hearing on the cost of prescription drugs. This hearing was the third in a series of Senate HELP committee meetings on drug prices and was held in response to the release of the National Academies of Science, Engineering, and Medicine’s report entitled “Making Medicines Affordable: A National Imperative”. At the hearing, Senator Murray (D-WA), ranking member of the Senate Health Committee, noted that the price of prescription drugs was one of the …
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Do Bundled Payments Have a Future in Medicare?
Katie Gudiksen, Senior Health Policy Researcher December 7, 2017
In an op-ed written for the Wall Street Journal on September 19, 2017, Seema Verma, the new administrator for the Centers for Medicare &|Medicaid Services (CMS), announced a “new direction” initiative for the Center for Medicare and Medicaid Innovation (CMMI).[1] The Affordable Care Act (ACA) created the CMMI to design and evaluate new payment models designed to either lower spending without reducing the quality of care, or improve the quality of care without increasing spending.[2] The CMMI established payment initiatives that used Medicare to test and implement payment reforms that …
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Has the Problem of Increasing Drug Prices Really Passed?
Katie Gudiksen, Senior Health Policy Researcher November 22, 2017
The rate of increase in spending on pharmaceuticals is declining, according to a Quintiles-IMS Health report from May of 2017.[1] In 2016, the rate of increase in spending on pharmaceuticals was only 4.8% on a net basis (i.e. including rebates and discounts) – less than half that in 2014 and 2015, although it remains much higher than inflation. Express Scripts, one of the largest Pharmacy Benefit Managers (PBMs) in the U.S., reports that in their employer-based plans, per-person spending on prescription drugs increased just 3.8%, much lower than previous years.[2] …
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Drug Money Part 4 – The Return of the CREATES Act: Fourth Time’s a Charm?
Katie Gudiksen, Senior Health Policy Researcher October 25, 2017
The Creating and Restoring Equal Access to Equivalent Samples Act (or CREATES Act) is the latest attempt by Congress to intervene to prevent anticompetitive behavior in the pharmaceutical industry. The intention of the CREATES Act is “to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products.”[1] A bipartisan group of Senators introduced the most recent version of the CREATES Act into the current session of Congress on April 27, 2017, and Sen. …
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