HEALTHCARE COSTS
Source Shorts: Medicare Officially Kills Program to Pilot Pharmaceutical Payment Reform
Katie Gudiksen, Senior Health Policy Researcher October 4, 2017
The Centers for Medicaid and Medicare officially dropped any attempt to implement a pilot program that would change the way drugs were reimbursed under Medicare Part B. This pilot reform attempt has been on hold for more than a year, but CMS has now officially withdrawn it. How does Medicare Part B cover prescriptions? Medicare Part B only covers drugs that are administered in a doctor’s office or clinic, which are primarily intravenous and injectable drugs (the bulk of pharmaceuticals are covered under Medicare Part D and would not …
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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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Drug Money Part 3: How do International Drug-Pricing Policies compare to U.S. Policies?
Katie Gudiksen, Senior Health Policy Researcher September 27, 2017
Introduction As discussed in earlier Drug Money Issue Briefs, spending on pharmaceuticals is a large and growing concern in the United States and the world. In 2013, the countries in the Organization for Economic Co-operation and Development (OECD) spent $800 billion, accounting for nearly 20% of all health expenditures.[1] Even among OECD countries, however, the U.S. stands out for large spending on pharmaceuticals. In 2014, the U.S. spent $1,112 per capita on pharmaceuticals – more than double the average spending for the countries in the OECD and ~40% more than …
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Academic Articles & Reports Roundup: September 2017
Source Fellow September 27, 2017
By: Katie Beyer, Student Fellow Happy October! In this Roundup of articles from the past month, we cover four articles from September. The topics this month include 1) actual R&D costs for single cancer pharmaceuticals|2) policy solutions beyond antitrust to promote competition and regulate consolidation|3) reasons behind market exclusivity for prescription drugs|and 4) state policy recommendations curbing healthcare consolidation efforts. Actual R&D Costs for Single Cancer Pharmaceuticals A 2017 Tufts University Center for Study of Drug Development and Research estimated the total cost of research and development (R&D) spending is $2.7 …
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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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Drug Money Part 2: A Look at 2017 State Legislative Efforts to Reduce Prescription Drug Prices
Source Fellow August 3, 2017
By: Katie Beyer, Student Fellow INTRODUCTION It is no secret that drug prices have been rising at an alarming rate. In fact, spending on prescription drugs rose 12.4% in 2014 and 9% in 2015.[1] In 2015, the U.S. spent $457 billion on prescription drugs, which accounted for 16.7% of overall healthcare services.[2] In 2016, Americans filled 4.4 billion drug prescriptions, at a total cost of approximately $400 billion.[3] On average, Americans spend $1,370 out of pocket on prescription drugs per year.[4] With an average annual price increase of approximately 10% over …
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Academic Articles & Reports Roundup: July 2017
Source Fellow August 1, 2017
By: Katie Beyer, Student Fellow Happy August! In this Roundup of articles from the past month, we cover four articles from July. The topics this month include 1) causes of recent drug price increases and how to reduce them|2) recent trends in health spending by state from 1991-2014|3) analysis of SHOP programs in California and Colorado|and 4) justifying universal health insurance. Causes of Recent Drug Price Increases and How to Reduce them The article Getting to the Root of High Prescription Drug Prices summarizes the major causes of rising prescription drug …
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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 and Reports Roundup: March 2017
Anna Zaret, Managing Editor April 2, 2017
Happy April! We hope you are enjoying the start of longer and warmer days. This month’s roundup includes articles from March about 1) the impact of reference pricing|2) policies to promote healthcare market competition|3) chargemaster list prices|and 4) ACA enrollment figures. 1) The Impact of Reference Pricing Reference Pricing Changes the ‘Choice Architecture’ Of Health Care For Consumers published by James C. Robinson, Timothy T. Brown, and Christopher Whaley (Health Affairs), discusses how reference pricing has impacted provider prices, patient choices, quality of care, and employer expenditures. The authors …
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Academic Articles and Reports Roundup: February 2017
Anna Zaret, Managing Editor March 3, 2017
February brought us a number of interesting articles and reports on healthcare price and competition issues. This month’s Roundup covers publications about 1) projected growth in national healthcare expenditures|2) ACA state marketplace competition|3) the relationship between payment reform and provider consolidation|and 4) the impact of the ACA on individual’s ability to buy insurance. We hope you enjoy! Projected Growth in National Health Expenditures Health Affairs published a report on National Health Expenditure Projections: 2016 – 25 by Sean P. Keehan and colleagues. According to the report, healthcare spending will continue …
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