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This Week in Health Care Reform: January 18th, 2019

As the focus on value promises to reshape our health care system, experts caution that it’s still about the prices; legislation is introduced to permanently repeal the harmful health insurance tax; lawmakers target drug prices; and, with hospitals now required to post prices for their services, some wonder just how useful that information is for consumers.

Week in Review

Health Care Prices: For all the attention being paid to value’s ability to bend the health care cost curve, the fact remains that it can only go so far unless something is done to address rising prices.  For their part, researchers continue to mine available data in the hopes of developing a more comprehensive understanding of why health care spending keeps going up.  That analysis points to a host of factors driving up the total cost of care, from high administrative costs to the uninsured.  Additional insights suggest that increased medical interventions for specific conditions could result in greater overall cost-effectiveness.  In the end, though, experts maintain that any possible solution will likely involve some permutation of value-based payment models, customized for different patient populations.

HIT Repeal: Senate lawmakers, having just reconvened, wasted no time last week offering up legislation aimed at repealing the burdensome health insurance tax (HIT).  Proposed by Sens. John Barrasso (R-Wyoming), Cory Gardner (R-Colorado), and Kyrsten Sinema (D-Arizona), the proposed bipartisan bill would permanently repeal the HIT, which is scheduled to return next year.  Recent estimates project the tax would raise $161 billion in federal revenues over a 10-year budget window, costs that would ultimately be borne by hard-working American families, small businesses, and seniors.

Drug Pricing Legislation: While new specialty drugs have largely been blamed for the breakneck speed at which drug prices have risen in recent years, research actually shows that medicines that have already been on the market for years are mostly responsible for the severe uptick in the price of brand-name drugs.  Separately, with pharmaceutical manufacturers already having returned to their old pricing tactics, a new study goes on to show that prescription drug prices in the United States are outpacing inflation.  Signaling their intent to make the issue a priority, Congress returned last week and immediately rushed to map out how they would address escalating drug prices, including a hearing scheduled for later this month and proposed legislation to curb costs

Hospital Transparency:
In pursuit of greater cost transparency in health care, hospitals are now required to post their list prices online.  While the initial aim had been one of providing consumers with greater tools in their own health care decision-making, the reality thus far is closer to one of jumbled medical codes, indecipherable abbreviations, and confusing dollar signs.  Nevertheless, the information that is now being made available still provides some valuable insights into the murky world of hospital prices – it just remains to be seen whether or not that information can benefit consumers.      

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