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This Week in Health Care Reform - April 22nd, 2016

Stakeholders continue their efforts to rein in rising drug costs; a new study highlights the savings potential of an increased focus on chronic care; an insurer announces its intention to broadly exit the exchange market; and, telehealth establishes new footholds.


Week in Review

Rx Bedfellows: A new survey this month seeks to shine a light on the struggles that consumers and patients face with regards to the escalating cost of prescription drugs.  Conducted on behalf of AARP, the survey of 50+ year old adults also sought to gauge views of how these drugs and their manufacturers are regulated, whether or not pharmaceutical companies influence politicians and health care professionals, and what can be done to help reduce the costs of prescription drugs.  Amongst the key findings: Three-quarters of respondents took prescription drugs on a regular basis; nearly half were worried about being able to afford their medicines; and, most thought that drugs were too expensive and that elected officials should support efforts to make them more affordable.  The results only serve to reinforce an issue with which governments, employers, insurers, and providers have been grappling for some time.  While there isn’t always agreement on what should be done, that there’s space here for a broader, more open dialogue is something that seems to be finding traction.  On a related note, it was announced this week that Walmart, the nation’s largest employer, had joined the Campaign for Sustainable Rx Pricing (CSRxP), a broad coalition of health care stakeholders whose goal is to foster an ongoing conversation around the costs of drugs.  The addition of Walmart to the Campaign’s ranks signifies, not just how far-reaching the issue of sustainability in prescription drug pricing has become, but that finding our way to a lasting solution will require cooperation from every corner of the health care landscape.

Chronic Care Focus: As our relationship to our health care continues to evolve, so, too, does our understanding of what’s driving the costs associated with its delivery.  With 5 percent of the population accounting for more than half of all spending, our health care costs have become increasingly concentrated.  Many of these patients suffer from multiple chronic conditions and their complex care needs haven’t always been well served by our fragmented health care system.  A new study, though, from the Partnership to Fight Chronic Disease, highlights some of the innovative ways that plans and providers are focusing their efforts to deliver the kind of coordinated, comprehensive care, where and when it can be most effective, while offering up recommendations for what more can be done to ease the burden of chronic disease on our health care system.

On its earnings call this week, health insurer, UnitedHealthcare, announced that it would be dropping out of the exchanges in all but a handful of states in 2017, citing mounting losses from their continued participation in the insurance exchange marketplace.  While the impact of their announcement will vary by state, other insurers have reaffirmed their commitment to trying to make the exchanges work.

The application of digital technology to the health care delivery space continues to transform where, how, and even when, we access health care.  Telehealth’s ability to ease traditional barriers to care has led to increased access and better clinical outcomes across a variety of settings.  For instance, urgent care providers, recognizing how telehealth can help reduce wait times, have warmed to the idea of investing in these technologies.  Meanwhile, the utilization of telehealth has also found support amongst mental health professionals, who’ve slowly incorporated the enhanced use of new technologies into their care delivery practices.

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Looking Ahead

House Republicans this week made known their intention to release their latest attempt aimed at replacing the Affordable Care Act.

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