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HEALTH ACTION NETWORK - ADVOCATES FOR BETTER HEALTH CARE SOLUTIONS

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This Week in Health Care Reform: June 15th, 2018

Lawmakers look to legislatively tackle the opioid crisis; a hearing is held exploring what can be done about the rising cost of prescription drugs; meanwhile, those prices keep going up; and, technology’s role in addressing social determinants of health is explored.

Week in Review

Opioid Legislation: This week, House lawmakers trained their sights on the opioid epidemic ravaging families and communities across the country.  Having set aside the next two weeks to focus on opioid legislation, the chamber wasted no time, passing dozens of bills to combat rising drug-related deaths from painkillers and heroin.  While their energies have undoubtedly moved the conversation forward, it remains unclear whether or not this output will coalesce into the kind of meaningful national policy that stakeholders are looking to Washington to produce.  On a separate, but related track, the NIH also released its outline of how it intends to spend the $500 million it was given by Congress to combat the opioid epidemic.

Rx Hearing: Also on Tuesday, Health & Human Services (HHS) Secretary Alex Azar appeared before the Senate HELP Committee to answer questions regarding the Administration’s plan to reduce prescription drug costs.  In presenting the outline for their blueprint, the HHS chief laid out a handful of possible approaches, including the elimination of drug rebates.  The Secretary also found himself having to expand on the Administration’s behind-the-scenes conversations with the pharmaceutical industry, stemming from the President’s statement at the end of last month that drugmakers would be announcing voluntary significant price reductions by this week.

Rx Prices:
Even as the HHS Secretary reinforced the Administration’s message and tone on tackling escalating drug prices, analysis continues to point to the toll that the rising cost of drugs is continuing to exact on patients.  Last week, a new report from the HHS Inspector General found a 62 percent spike in federal spending in the Medicare Part D prescription drug program between 2011 and 2015 despite the total number of prescriptions declining over that same period.  In highlighting this alarming trend, observers point to one undeniable takeaway – that giant price hikes are costing taxpayers and the government a lot of money.  Further, that because drug companies still control so much of the health care system’s wealth, any meaningful attempt to bring down these costs would have to, by necessity, target their pricing mechanism (specifically) or the US patent system (generally).

Technology & SDoH:
Perhaps no two issues better encapsulate our health care system’s pursuit of systemic improvements than that of telemedicine and social determinants of health (SDoH).  While the ideas catalyzing the latter – namely, that social and environmental factors influence health outcomes – are grounded in historical context, it’s the growing emphasis on the former that many believe will usher in something of a sea change in regards to what the next iteration of our health care system will ultimately look like.  However, what’s less clear is how soon we’ll benefit from the interplay between the two.  A new report seeks to provide some insight into the, as yet, untapped potential of bringing health technologies to bear in the burgeoning institutionalization of SDoH into the larger health care delivery model.  Until providers find the best way to effectively leverage data, the SDoH technology market will remain relatively weak.  Currently, according to that report, fewer than 4 percent of health systems and managed care organizations have invested in these technologies.  But, the need for standardization around data capture and communication between health care providers and community partners is projected to drive adoption rates up to as much as 15 percent by 2023.      

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Spotlight

It’s no secret that policy and regulatory changes continue to pose challenges to the individual insurance market.  But, there are myriad factors placing upward pressure on premiums, including pharmacy costs, medical trend, and the health insurance tax.  Take an in-depth look at what’s driving premiums in 2019.
                                            
                                            

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