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HEALTH ACTION NETWORK - ADVOCATES FOR BETTER HEALTH CARE SOLUTIONS

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This Week in Health Care Reform: August 18th, 2017

A new analysis projects the impact of cutting off funding to CSRs; the rising cost of older drugs threatens to overwhelm Medicaid; and, the number of employers offering telehealth benefits is on the rise.

Week in Review

CBO's CSR Analysis: Earlier this week, the nonpartisan Congressional Budget Office (CBO) released its analysis of what would happen should funding to the Affordable Care Act’s cost-sharing reduction (CSR) subsides be eliminated.  Prepared at the request of House Democratic leadership, CBO estimated that if CSRs were to end this year some health insurance premiums would go up by as much as 25 percent by 2020.  Further, the analysis also found that halting these payments would, in fact, increase the federal deficit by $194 billion over the next decade.  Just what effect that may have had on the Administration’s immediate thinking is unclear, but it was announced Wednesday evening that the government would be making this month’s CSR payment, despite previous overtures to the contrary.  Nevertheless, experts caution that the month-to-month uncertainty plaguing these payments only serves to further undermine the stability of the individual exchange markets.

Medicaid's Rx Threat:
Much has been made (understandably) about the impact that rising drug prices are having on our health care system.  And, while a lot of those energies have focused on the steady stream of high-cost specialty drugs making their way to the market, less attention has been paid to what’s been going on with the generic and brand name drugs that are already there – some of them for decades.  But, a new analysis from Kaiser Health News is shining a spotlight on how price increases to these drugs are threatening to overwhelm Medicaid.  Specifically, when compared to 2015, rising costs for 313 brand name drugs lifted prescription drug spending in Medicaid by as much as $3.2 billion last year.  In fact, nine of those drugs have been on the market since 1970.  Data went on to reveal that expenditures on a further 67 generics and other non-branded drugs cost taxpayers an extra $258 million in 2016.

Employers' Telehealth Benefits:
Initially treated as more of a fringe benefit, telehealth no longer finds itself relegated to the margins of employee compensation packages, at least according to a new study from the National Business Group on Health (NBGH).  In a survey of nearly 150 employers, NBGH researchers found that nearly all of them (96 percent) said that they planned to make telehealth services available to their workers as a benefit.  Further, more than half (56 percent) said that they would also offer tele-behavioral health services next year.  While its increased integration into structured employee benefit design packages is largely a reflection of employers’ increased desire to lower overall health care costs, 20 percent of respondents said that they’re seeing utilization rates of 8 percent or more, indicating that their workers, too, are taking advantage of what telehealth has to offer.      

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Spotlight

A new collaboration between Anthem BlueCross and AmericasHealth Plan in California looks to promote value-based care best practices for Medicare Advantage beneficiaries in the San Fernando Valley and Ventura County.  The partnership will focus on enhanced care coordination, with an emphasis on preventive health and better management of chronic conditions, in the hopes of lowering costs and unnecessary utilization rates.
                                            
                                            

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