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This Week in Health Care Reform - November 11th, 2016

Bipartisan voices urge for the extension of relief from an unpopular tax; the price of insulin soars, as a beleaguered industry continues to defend itself; and, value in insurance design paves the way to health care savings.

Week in Review

HIT Relief: Efforts to extend the moratorium on the burdensome health insurance tax (HIT) continue to draw broad, bipartisan support.  As a reminder, at the end of last year, Congress passed a one-year suspension of the HIT (the tax levied against insurers by the Affordable Care Act), thereby temporarily sparing hard-working families, small business owners, and seniors from its impact.  Late last month, members of the Stop the HIT Coalition sent a letter to Congressional leaders urging them to pass an extension of the HIT suspension, providing much-needed continued relief to those least likely to be able to afford paying it.  Separately, a bipartisan group of House members sent a letter of their own to their respective leaders requesting that another one-year suspension of the HIT be included in the upcoming lame duck session.  Learn more about the HIT and add your support to the efforts to eliminate it and its onerous burden by visiting the Stop the HIT Coalition’s website.
Latest Rx Price Hike:
With the EpiPen outrage still fresh in consumers’ minds, the skyrocketing price of another life-saving drug threatens to push the issue of rising drug costs over the tipping point once and for all.  According to a new analysis, over the course of the last eight years, the average price of insulin has gone up more than 200 percent per milliliter.  In fact, the list price for insulin by the only three companies manufacturing the drug in the US, have all risen by triple digits since 2004 – by as much as 400 percent – and, often times in lockstep with each other.  Insulin’s history encapsulates the complexities that have long shrouded the intricacies of the pharmaceutical market – namely, how long-established drugs actually become more expensive over time.  Meanwhile, as highlighted in a recent newsletter, the drug industry continues to mount a defense in its ongoing effort to push back against the tidal wave of consumer, patient, regulatory, and legislative sentiment rising up against it. 
As also covered in a previous newsletter, the growing influence of consumer centricity in our evolving health care landscape.  A component piece of this focus is the emphasis on integrating value into our health care decision-making paradigm.  A new McKesson study seeks to gauge stakeholder comfort with the transition to more value-based insurance design (VBID) in health care.  Two of those groups, payers and providers, both expressed their belief in making new value-based reimbursement models work financially, although providers haven’t quite caught up to payers, yet.  Regardless, the operating principle behind the approach – that the inherent flexibility provided by VBID leads to improved quality of care while reducing costs – is one that’s steadily gaining traction.  And, none too soon, it would seem, as a separate study identifies more than half of all Americans suffer from at least one chronic condition.  Given that complex care drives so much of our health care costs (60 to 70 percent, according to the McKesson study), there’s a growing sense that value will undoubtedly play a role in containing costs going forward.

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