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This Week in Health Care Reform - November 4th, 2016

A new study projects double-digit increases for drug prices next year; consumerism continues to make inroads in the health care decision-making process; telehealth’s reach expands; and, for the fourth time, open enrollment on the exchanges begins.

Week in Review

Rx Price Increases: Prescription drugs have firmly established themselves as one of the primary drivers of health care costs in this country.  While specialty drugs have garnered a lot of the attention – justifiably so, when you consider that this class of drugs alone accounts for 35 percent of the overall drug price trend despite comprising less than 1 percent of all prescriptions – the overall cost of drugs continues to go up.  In fact, the cost of drugs prescribed to employees under the age of 65 is expected to grow 11.6 percent next year, and that’s on top of the 11.3 percent hike experienced this year.  With almost half of all Americans having taken at least one prescription medication in the past month, it’s clear that the pressing issue of rising drug prices has far-reaching consequences for the entirety of our health care system.  Which is why stakeholders across the spectrum have spoken out, shining a spotlight on the need to find lasting solutions to a problem threatening all of their constituencies, with federal officials, payers, states, and physicians all having marshaled their energies to address the issue.
Comparison Shopping: Ancillary to the attention that’s been paid to the issue of rising prescription drug prices is the increased focus on finding ways to make value a component piece of our evolving health care decision-making matrix.  Whether that’s an emphasis on quality or a push to better align reimbursement with results, consumerism has asserted itself as something of a divining rod as we reimagine our health care system.  However, health care consumers have yet to really demonstrate the same price-conscious fluency that’s on display when they’re faced with other purchasing decisions.  Much of that has to do with the lack of price transparency, which only exacerbates the persistent disconnect between health care consumers and the services they’re paying for.  But, as costs continue to rise, so, too, has the demand for giving people the tools they need to make better, more informed health care choices.  For instance, some employers, in an effort to encourage their workers to comparison shop, have begun to give their employees a cut of the savings when they choose less expensive alternatives.  Meanwhile, others have made new tools available to their workers, allowing them to compare prices for common procedures, rewarding them when they opt for lower-cost options.
Digital Health:
Telehealth continues to redefine how and when and where patients connect to their health care.  New technologies, such as tracking systems that allow clinicians to monitor patient conditions in real time, are quickly turning the skeptical into the converted, insofar as telehealth’s utility and applicability are concerned.  And, the growing body of research into telehealth’s benefits, such as a recent study highlighting the efficacy of an interactive treatment strategy for diabetes management, only serves to strengthen proponents’ call for our system to better integrate digital tools into the health care delivery paradigm.  Ultimately, though, it’s the increased access to care, better patient outcomes, and realized cost savings that serve as the most effective argument for telehealth’s widespread embrace. 
Open Enrollment:
Open enrollment on the insurance exchange marketplaces began this past Tuesday, meaning consumers are now able to shop for health coverage for 2017.  While a lot has changed since the exchanges first opened for business four years ago, the fact that the window during which consumers can explore their options is limited has remained the same, as shoppers will need to have signed up by December 15th for coverage on January 1st.  Politics aside, consumer traffic on the exchanges has been significant, with the website handling 50 percent more eligibility applications on Tuesday than the first day of open enrollment last year.

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Looking Ahead

Ahead of Election Day, drug prices have supplanted the health care law as the top health care priority for voters for 2017.  And, before heading to your polling station, here’s a quick analysis of the major Presidential candidates’ positions on health care policy.

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