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This Week in Health Care Reform - October 23rd, 2015

As Medicare spending for hepatitis C drugs surges, concern mounts for the Part D prescription drug program; social media monitoring is shown to improve health care, as more interconnected adults take advantage of digital tools to manage their health; and, a consensus is emerging among the GOP on a way forward where the health care law is concerned.


Week in Review

Part D Worry: In the decade since it first came into existence, Medicare’s Part D prescription drug program has largely been regarded as a success.  However, with drug costs on the rise – especially for costly new breakthrough medicines, such as those used to treat hepatitis C, which, on its own, cost Part D $4.8 billion last year – there’s growing concern that the program’s ability to help beneficiaries manage their treatment expenses and options is dwindling.  The issue was addressed at a panel discussion in Washington this week at the National Conference on Medicare hosted by America’s Health Insurance Plans (AHIP).  Featuring perspectives from across the health care spectrum, panelists were divided when trying to reconcile the price of drugs as the inherent cost of innovation.  Regardless, with the current pipeline of drugs reaching unprecedented levels, it’s getting increasingly harder to deny that the system is rapidly approaching something of a crisis point.  And, as recent events have exposed, it’s not just the influx of new drugs we need to worry about, as older, long-established, generic drugs now find themselves swept up in the conversation, too.  

Connected Health: The health care sector is slowly figuring out how to take advantage of our interconnectedness - as both consumers and patients - by trying to weave social media into its normal course of operations, beyond just education and outreach.  This has resulted in an increased focus on monitoring the social space for real-time events, while mining big data to lead to improved health outcomes, all in the hopes of unlocking the medium as an informational resource.  Given that so many people already use social media as a primary news source, it stands to reason that the information stream can also serve as a situational intelligence tool or crisis communication mechanism.  Hospitals, evidently, tend to agree, as 40 percent say they currently use social media as a communication tactic.  And, it would seem, none too soon, with evidence continuing to point to consumers’ increased comfort in using digital tools to manage their health.

GOP Consensus:
As we continue the long march towards next year’s elections, it’s not hard to imagine that health care will cast an increasingly long shadow across the campaign trail.  With that in mind, some believe that the GOP, with an eye on recapturing the White House next November, has slowly begun to coalesce around a plan to repeal and replace the health care law.  With proposals already put forth by Presidential rivals Sen. Marco Rubio (R-Florida) and former Florida Governor Jeb Bush, in addition to former hopeful, Wisconsin Governor Scott Walker, Republicans seem to be approaching something of a consensus on the general outlines of a plan – which is not to say that they’re any closer to enacting it.  Still, experts recognize this progress as the continuation of an evolving stance for the GOP, at least where the Affordable Care Act is concerned.

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Looking Ahead

Despite the concerted efforts leading into the next open enrollment period for the exchanges, hurdles remain, prompting lower estimates for sign-ups.  Meanwhile, the House anxiously waits to see who will pick up the Speaker gavel next, with the election scheduled for next Wednesday

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