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This Week in Health Care Reform: March 30th, 2018

A new report highlights the burden of rising drug prices on seniors; telehealth continues to make inroads; and, experts point to price transparency as being a necessary ingredient in health care consumerism.

Week in Review

Rx Report: According to a new congressional analysis, the prices of some of the most commonly prescribed brand-name drugs taken by seniors have increased nearly ten times the annual rate of inflation since 2012.  The report, released this past Monday, examined the costs of the twenty most-prescribed drugs under the Medicare Part D prescription drug program over a five-year period (2012-2017).  The results only serve to underscore exactly why so much attention has been devoted to the issue of out-of-control drug prices.  Twelve of those drugs experienced price increases of more than 50 percent, while six had increases of over 100 percent.  The lowest percentage increase observed was still high (31 percent), but pales in comparison to the 477 percent seen for one drug at the extreme opposite end of the spectrum.  In breaking down the math, the average price increase across the drugs examined worked out to 12 percent every year over the five-year period, significantly outpacing inflation.  The report was released by Sen. Claire McCaskill (D-Missouri) and prepared at her request, alongside that of the minority staff of the Senate Committee on Homeland Security and Governmental Affairs.  Researchers concluded the report by highlighting how critical a concern soaring pharmaceutical drug prices remain for patients and policymakers, regardless of their age.  “Over the last decade,” they close, “these significant price increases have emerged as a dominant driver of U.S. health care costs – a trend experts anticipate will continue at a rapid pace."

Telehealth Adoption:
There’s a growing appetite amongst health systems to build out more organizationally comprehensive telehealth platforms in their respective pursuits of a greater focus on connected health, rather than the more piecemeal approach that’s largely served as the blueprint for many health care organizations to this point.  At least, those are the takeaways from the latest annual telehealth industry survey released by telehealth vendor REACH Health.  Of the 411 health care executives polled, nearly half of them reported employing just such an enterprise-wide telehealth platform, a marked increase from what had been observed in previous surveys.  And, not only is this approach becoming more common, it’s also proven to be more successful in proving the superior value of shifting towards an enterprise platform and away from a more limited departmental one.  However, despite these benefits, many organizations still have yet to embrace the transition to telehealth, as evidenced in a separate survey, in which 38 percent of respondents said they hadn’t yet done so because they just didn’t know how.

Transparency & Consumerism:
Health care consumers’ expectations continue to be reshaped by their experiences in the broader retail space.  As a result, experts caution that health care organizations would do well to adjust their own processes to better align with patients’ evolving consumption patterns, ergo, the increasing emphasis on consumerism in the health care delivery space.  A new public policy brief only serves to underscore the growing influence of factors beyond merely price – such as convenience and amenability to control – on an individual’s discretionary decision-making in regards to their health care.  Which isn’t to say that price isn’t still an important factor.  But, absent improved capabilities at the point-of-sale, health care organizations lack the ability to connect patient-consumers with meaningful price estimates.  A separate survey underscores the extent of this disconnect, with 63 percent of providers polled reporting health care price transparency challenges.  Regardless, experts cite the gradual shifting of financial risk to patients – as they’re being asked to assume more financial responsibility for their own care – as driving the inexorable march towards greater health care consumerism.

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As has been covered, stakeholders have spent the past couple of months rallying in support of Medicare Advantage.  With nearly 20 million seniors and persons with disabilities enrolled in the program, it’s not hard to imagine how important a role Medicare Advantage plays in the lives of so many.  The Centers for Medicare & Medicaid Services (CMS) released its annual proposed changes to Medicare Advantage early last month.  Those changes have the potential to impact how the program is both administered and funded beginning in 2019.  CMS’ finalized changes are expected to be released on the other side of the weekend.  Thanks to the hundreds of you, our Health Action Network members, who have supported the efforts to protect Medicare Advantage in the days and weeks leading up to CMS’ final announcement.  And, be sure to tune-in next week to learn more about those finalized changes.

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