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This Week in Health Care Reform - March 13th, 2015

Supporters continue to circle the wagons around Medicare Advantage; Rx spending growth explodes; technology remains poised to improve health care; and, the effort to repeal the health insurer fee finds bipartisan traction.


Week in Review

Support for Medicare Advantage: The conversation continues to build around preserving the popular Medicare Advantage program and protecting its 16 million beneficiaries from further disruption.  One way that supporters have looked to draw attention to the issue is by shining a spotlight on the program’s value proposition.  On Wednesday, the Alliance for Health Reform held a briefing in Washington highlighting the program’s emphasis on managing chronic illness as a fundamental component of its integrative care model.  Also weighing-in, hospitals, which, last week, sent a letter to the Centers for Medicare & Medicaid Services (CMS), in response to the Agency’s latest proposed changes to the underlying structure of the program that, if finalized, would only serve to further weaken Medicare Advantage’s ability to serve some of the country’s most vulnerable beneficiaries.  Noting the proposed cuts’ potential “significant downstream impact on beneficiaries and providers” the letter, submitted by the American Hospital Association (AHA), went on to raise the group’s concerns that these changes “would result in reduced payments to Medicare Advantage plans on the back of other cuts to the program, as well as limit the benefits of risk adjustment”, which encourages plans to design benefit packages tailored to higher-acuity patients.  Also this week, at its National Health Policy Conference, America’s Health Insurance Plans (AHIP) convened a panel of stakeholders representing a variety of constituencies to talk about how Medicare Advantage helps deliver better care and better health to their populations.  Finally, last week, we asked our Health Action Network members to contact their Members of Congress, urging them to reach out to CMS on behalf of Medicare Advantage beneficiaries all over the country – so far, more than 500 messages have been sent to elected officials!  There’s still time for you to join the efforts to protect the program and the millions of seniors and persons with disabilities who depend on its coordinated model of comprehensive care.  Be sure to take action! 

Rx Spending:
A new report underscores the growing threat to the sustainability of our entire health care system represented by drug prices.  Prepared for pharmaceutical benefit manager, Express Scripts, the study shows that drug spending in the U.S. rose 13.1 percent in 2014, the fastest rate in more than a decade.  Further analysis revealed that the trend in specialty drug pricing – such as new high-priced therapies for hepatitis C – more than doubled last year, to 30.9 percent.  Most alarmingly, though, despite only accounting for 1 percent of total U.S. prescriptions, specialty drugs represented 31.8 percent of the overall drug spend in 2014.  It’s hard to deny that this trend, should it continue, is unsustainable (all the more so given the number of new drugs in the pipeline), leading to increased calls for greater transparency from the pharmaceutical industry.

Health IT:
That technology will usher in a new era for health care delivery seems less a question of ‘if’ than ‘when’.  Given consumers’ increased comfort with technology, not to mention their improved health care literacy, it stands to reason that health IT is poised to grow, and in a big way.  Evidence continues to point to mobile technology leading to enhanced patient engagement.  Seniors, too, have expressed a willingness to embrace online options in how and when (and where) they access their care.

Insurer Fee Repeal:
With taxes foremost on many Americans’ minds, it should come as no surprise that many are looking to lawmakers to ease their burden.  One tax that’s finding itself increasingly in the crosshairs is the health care law’s health insurer fee, which is projected to reach $145 billion over the next ten years.  It is expected that consumers – families, seniors, and small businesses – will bear the brunt of the impact in the form of higher premiums and higher out-of-pocket costs.  But, there’s growing bipartisan support to repeal the onerous tax and eliminate it for good.

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We encourage you to stay involved as implementation efforts surrounding health care reform progress.  Visit the Health Action Network and be sure to let us know what's on your mind.


Looking Ahead

As highlighted, Health Action Network members continue to show their support for Medicare Advantage and its enrollees.  If you haven’t already, there’s still time to add your voice to the collective call to protect the program by urging lawmakers to reach out to CMS to ask them to preserve Medicare Advantage from further, harmful cuts. 

You can keep up with the latest by following the Health Action Network on Twitter and by liking us on Facebook.