This Week in Healthcare Reform: October 2nd, 2020

Lawmakers reignite negotiations on the next coronavirus stimulus package; drugmakers bend patent rules to protect their pricing power; an in-depth look at what’s driving health care spending; and, how technology is helping better address population health.

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Week in Review

Coronavirus Talks: On Monday, House Democrats unveiled their latest COVID-19 relief bill in an effort to jumpstart stalled negotiations with Administration officials and Senate Republicans.  The proposal, which represents a scaled-down version of the bill they passed back in mid-May, clocks in at $2.2 trillion – fully $1.2 trillion less than the original HEROES Act.  Treasury Secretary Steve Mnuchin met with House Speaker Nancy Pelosi (D-California) Wednesday morning in the hopes of working out a compromise with the Administration’s own plan, which comes in at just over $1.6 trillion.  Unable to find their way to an agreement after that meeting, the Speaker agreed to postpone the initial vote, before the House ultimately passed their bill yesterday evening along party lines.  That vote, however, doesn’t preclude the possibility of a bipartisan deal, as negotiations continue.

Product-Hopping: A practice employed by Big Pharma demonstrates the tremendous cost to our health care system from just one of the numerous anti-competitive tactics used by pharmaceutical manufacturers to protect their bottom lines.  Known as “product-hopping”, this tactic involves brand-name drugmakers switching patients to a reformulated version of their drug just prior to that drug’s existing patent expiring.  Now, a new study has put a price tag on just how much that practice costs our health care system annually.  According to the analysis from Matrix Global Advisors and commissioned by the Coalition for Affordable Prescription Drugs (CAPD), product-hopping adds at least $4.7 billion per year to what we’re already paying for our drugs.  That figure actually only captures the cost of product-hopping for just five brand-name drugs.  The study’s authors go on to say that Big Pharma uses this tactic to preserve their monopolies, while preventing generic competition.

Spending Drivers: In the still-unfolding aftermath of the coronavirus pandemic, the focus on rising health care costs has only taken on more significance.  And, while prescription drug prices continue to distinguish themselves as one of the main drivers of escalating health care costs (as touched on above), a new analysis points to an entirely different component of health care spending as being the main driver of rising costs – specifically, hospital and physician payments.  According to the latest Peterson-Kaiser Tracker analysis, we spend twice as much on health care as comparable countries, driven mostly by significantly higher payments to providers.  In 2018, health spending in the U.S. was nearly twice as much per person versus comparable countries ($10,637 compared to $5,527) – the largest spending category in both being for inpatient and outpatient care, which includes hospitals, physicians, and clinics for services and fees stemming from primary care, specialty visits, surgical care, and facility and professional fees.  In fact, Americans spent considerably more on these payments ($6,624 compared to $2,718) on average. 

Population Health: As our understanding of the role that population health management plays in our ability to improve health outcomes for vulnerable and underserved communities evolves, so, too, does our appreciation for the importance of developing the right tools to help us better deliver on that potential.  Which is why stakeholders are increasingly turning to technology as they seek to operationalize population health management into their care delivery models.  Specifically, the tailored insights that can be mined through enhanced data analytics when applied to these populations help to create the conditions that lead to better health outcomes.  Technology allows for the collection of updated patient data, which, in turn, allows stakeholders to identify and address chronic illnesses and common health issues by geography or demographics or other relevant groupings.  This enables a more customized approach to care delivery based on the surrounding community’s urgent care needs.


A new poll from the Commonwealth Fund takes a look at voters’ health care priorities in key battleground states ahead of Election Day.

Stay safe and be well.

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