Tag: Insurance Pricing

Medicare Part A will run out of funds in 8 years, Medicare trustee report says | Healthcare Finance News

Medicare Part A will run out of funds in 8 years, Medicare trustee report says | Healthcare Finance News

“Absent a change in the delivery system or level of update by subsequent legislation, access to Medicare-participating physicians may become a significant issue in the long-term under current law,” trustees said. They recommend the consideration of reforms to prevent the widening of this gap. If the health sector cannot transition to more efficient models of […]

State Policies to Address Prescription Drug Prices | Center for American Progress

State Policies to Address Prescription Drug Prices | Center for American Progress

Over the past few years, high and rising prescription drug prices have generated significant controversy. Large, bipartisan majorities of the public support increased government action to reduce drug prices.1 However, little action has been taken at the federal level to reduce prices. Despite President Donald Trump’s repeated promises during the campaign to crack down on […]

Prices that insurers pay can help end hospital price gouging | TheHill

Prices that insurers pay can help end hospital price gouging | TheHill

Last month the Texas Supreme Court decided In Re Cypress Medical Center, a case focused on whether the payments hospitals receive for insured patients are relevant to determining the price an uninsured or out-of-network patient must pay. The question of how to measure the reasonable and customary value of health care services is being raised […]

Cassidy Health Care Proposal | The Daily Caller

Cassidy Health Care Proposal | The Daily Caller

The senator, along with GOP Sen. Lindsey Graham of South Carolina, wrote a bill last fall that would have drastically cut down on federal spending toward Obamacare and gave greater flexibility to states in how they chose to implement the health care law. Cassidy and his team are now focusing their efforts away from repeal […]

To Lower Your Medicare Drug Costs, Ask Your Pharmacist For The Cash Price | NPR

To Lower Your Medicare Drug Costs, Ask Your Pharmacist For The Cash Price | NPR

A simple question at the pharmacy could unlock savings for millions of Medicare beneficiaries. Under a little-known Medicare rule, they can pay a lower cash price for prescriptions instead of using their insurance and doling out the amount the policy requires. But only if they ask. That is because pharmacists say their contracts with drug […]

Say what? How an $800 charge for hearing aids soared to a $3,600 healthcare bill | Los Angeles Times

Say what? How an $800 charge for hearing aids soared to a $3,600 healthcare bill | Los Angeles Times

You almost get the feeling that insurance companies are doing everything they can to avoid having to cover a legitimate (but pricey) medical expense. The President’s Council of Advisors on Science and Technology said in a 2015 report that a single hearing aid costs an average of $2,300. Most people need two. Nowadays, top-of-the-line models […]

Trump’s drug pricing plan: light on details, heavy on questions | PharmaTimes

Trump’s drug pricing plan: light on details, heavy on questions | PharmaTimes

Better negotiation As a group, the proposals pertaining to better negotiation are most likely to influence access and reimbursement in the US pharmaceutical market. Currently, Medicaid manages drug spend through preferred drugs lists but is unable to block drugs from the formulary. Experiments directed at replacing the Medicaid preferred drug list with formulary management in […]

Trump’s Drug Blueprint Could Alter PBM Contracting | SHRM

Trump’s Drug Blueprint Could Alter PBM Contracting | SHRM

With much fanfare, President Donald Trump’s administration recently released a 44-page blueprint for executive action on drug pricing titled American Patients First. The blueprint proposes steps to end drug manufacturers’ “gaming” of the regulatory process and to create incentives for pharmaceutical companies to lower list prices. The proposals regarding pharmacy benefit manager (PBM) firms, in […]

Pass pharma discounts onto patients, not ‘highly-paid middlemen’, says expert | thepharmaletter

Pass pharma discounts onto patients, not ‘highly-paid middlemen’, says expert | thepharmaletter

Dr Matthews said: “Price transparency in health care, and especially pharmaceuticals, has become a major policy debate. “But price transparency is a problem in the whole health care system. Try calling a hospital to get a quote for the cost of an appendectomy. At least with prescription drugs, a patient can obtain and compare prices […]

Would requiring drug advertisements to list price tags really help lower prices? | THE BUSINESS TIMES

Would requiring drug advertisements to list price tags really help lower prices? | THE BUSINESS TIMES

IF US President Donald Trump has his way, television viewers who see commercials for the drug Keytruda will learn not only that it can help lung cancer patients, but also that it carries a price tag of US$13,500 a month, or US$162,000 a year. Viewers who see advertisements for Neulasta, a drug that reduces the […]