Cost-Sharing or Out-of-Pocket Costs
The Source Roundup: June 2018 Edition
Source Fellow June 1, 2018
By: Megan O’Leary, Student Fellow Happy June! In this edition of the Source Roundup, we cover five academic articles and reports from April and May. The topics this month include: 1) barriers for generics to lower specialty drug prices, 2) a call to reform pharmaceutical systems in the United States and Canada, 3) efforts by states to stabilize the individual market, 4) Vermont’s push for community-driven health care reform, and 5) antitrust lawsuits in the pharmaceutical industry. Barriers for Generics to Lower Specialty Drug Prices The Health Affairs article Generic …
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Will Putting “American Patients First” Result in Lower Drug Prices?
Katie Gudiksen, Senior Health Policy Researcher May 30, 2018
On May 11, 2018, the Trump Administration released American Patients First, a blueprint to lower drug costs (the blueprint). The report details four challenges with the prescription drug market, including high list prices for drugs, high and rising out-of-pocket costs for patients, government programs that overpay for drugs due to the lack of negotiation tools, and foreign governments “free-riding” off of American investment in innovation. To address these challenges, the report also lays out four key strategies for reform, including a list of more than fifty recommendations with both immediate and …
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How the 2017 Tax Reform Act May Impact Healthcare Costs and Spending
Source Fellow January 11, 2018
By: Katie Beyer, Student Fellow The 2017 Tax Reform Act, formerly known as H.R.1 the Tax Cuts and Jobs Act, was signed into law by President Trump on December 22, 2017. This politically charged bill first passed the Senate by a strict party line vote of 51-48 and passed the House by a final vote of 224-201. No Democrats voted for the bill in either the Senate or the House. Republicans were eager to pass the bill, claiming that families would see an average of $2,200 cut from their annual taxes.[1] …
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The End of CSRs: Trump Eliminates “Bailouts” While Others Seek a Solution
Source Fellow October 30, 2017
By: Briana Moller, Student Fellow Trump Administration Has Eliminated CSR Payments On October 11, 2017, in a memo to the Department of Treasury and the Department of Health and Human Services (HHS), Attorney General Jeff Sessions provided his legal opinion that Cost Sharing Reduction (CSR) payments were unlawful. CSR payments reimburse insurance companies for losses in deductibles, copays, and coinsurance payments owed by lower income individuals in health plans on the Affordable Care Act (ACA) exchanges. The following day, Eric Hagan, the acting Secretary of HHS, announced that CSR payments …
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Bailout or Bust? How CSR Payments Are in a Precarious State
Source Fellow September 29, 2017
By: Briana Moller, Student Fellow What’s Happened Earlier this year, President Trump began discussing the idea of eliminating cost sharing reduction (“CSR”) payments to insurance companies. (1) CSR payments are reimbursements the federal government provides to insurance companies that provide discounts to enrollees with incomes between 100 and 250% of the poverty line. (2) In a recent tweet, the President referred to CSR payments as “bailouts” to insurance companies and threatened to end these payments “very soon!” So what does this all mean? If President Trump eliminates CSR payments, insurance …
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Academic Articles & Reports Roundup: August 2017
Sammy Chang, Health Policy Researcher September 1, 2017
Happy September! In this Roundup, we cover four articles from July and August. The topics this month include (1) how states could use the excise tax to discourage forum shopping by insurance plans, (2) the effect of reference pricing on consumers’ drug selection, (3) proposals to promote the use of cost-effective technology in insurance, and (4) possible barriers that prevent consumers from seeking out price information. How States Could Use the Excise Tax to Discourage Forum Shopping by Insurance Plans In How States Can Respond to the AHCA: Using …
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Academic Articles & Reports Roundup: June 2017
Source Fellow July 1, 2017
By: Katie Beyer, Student Fellow Happy July! In this Roundup of articles from the past month, we cover five articles all published in June. The topics this month include 1) Maryland’s anti-price gouging law|2) the 2018 medical cost trend|3) lowering generic drug costs through effective price transparency|4) state efforts to establish cost sharing standards|and 5) the effects of insurance coverage expansions. Maryland’s Anti-Price Gouging Law The New England Journal of Medicine published an article titled, Targeting Unconscionable Prescription Drug Prices – Maryland’s Anti-Price Gouging Law by Jeremy Greene, and William …
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Academic Articles & Reports Round Up: April 2016
Elizabeth Nicholson, Research Fellow May 2, 2016
Happy May! April produced a number of articles and reports on interesting aspects of healthcare issues. As always, healthcare cost was at the forefront of the scene. Also discussed were pharmaceutical cost, the intersection of quality and cost, cost-sharing, the likelihood of a single-payer healthcare system in the United States, the effects of the ACA’s Medicaid expansion, and the ins and outs of the new Medicare payment system. HEALTHCARE COST Health Affairs published an article entitled Study of Physician And Patient Communication Identifies Missed Opportunities To Help Reduce Patients’ Out-Of-Pocket …
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Academic Articles & Reports Round-up: October 2015
Elizabeth Nicholson, Research Fellow November 2, 2015
We hope everyone had a Happy Halloween! October provided a high volume of articles focused on an array of topics related to healthcare price and competition, so bear with us! One JAMA article, in particular, provided an umbrella view of the October healthcare literature. The article, entitled Insurers Again at Odds With Hospitals and Physicians, provides a historical analysis of the tension between health insurers and physicians/hospitals/pharmaceutical companies from the perspective of Harvard Economics Professor David M. Cutler, PhD. Dr. Cutler argues that what’s at the heart of the United States’ …
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