Direct Medicare Price Negotiation is Good for Payers

Slides:



Advertisements
Similar presentations
1 THE COMMONWEALTH FUND Uninsured Top Priority for Congress According to Health Care Opinion Leaders Source: The Commonwealth Fund Health Care Opinion.
Advertisements

1 THE COMMONWEALTH FUND Source: The Commonwealth Fund Health Care Opinion Leaders Survey, July Assessment of Medicare Part D Now that the first-ever.
The Implications of the New Medicare Prescription Drug Legislation for Health Care Providers Anthony A. Barrueta Senior Counsel, Government Relations Kaiser.
Many Medicaid Patients Could Face Higher Fees Under a Proposed Federal Policy The New York Times Robert Pear January 22, 2013
1 Rising Health Care Costs: Can we Move Towards Higher-Value Care? Katherine Baicker Professor of Health Economics Harvard School of Public Health.
Single Payer 101 Kao-Ping Chua Jack Rutledge Fellow, American Medical Student Association.
Healthcare Policy. I. A mostly private health care system A. Traditional approach: fee for service. Paid for by insurance. B. Rising costs of health care,
Analyzing and Reducing Costs. Plan for Today Review and reflect on Roulette Excel Exercise Relate exercise to major cost-reduction strategies of health.
Payment Reform/Medicare Reform/Cost Containment Group V.
Health Insurance Chapter 16. Types of insurance Commercial Blue cross HMO/PPO/PSO Medicare/Medicaid.
Exhibit 1. “Medicare Extra” Benefits vs. Current Medicare Benefits Current Medicare benefits*“Medicare Extra” Deductible Hospital: $1024/benefit period.
THE COMMONWEALTH FUND Figure 1. Barriers to Growth of Accountable Care Systems “In your view, how significant are the following barriers to growth of population-based,
1 Working Together for a New Foundation Pharmacy Solutions in Drug Plan Management October 22, 2014 Gary Coles, SVP, Group Administration.
Health care costs concern Americans most By JIM ABRAMS Associated Press Writer
Title text here Consumer Perspective on Containing Drug Costs Leigh Purvis, Director, Health Services Research.
Providing Insights that Contribute to Better Health Policy Health Plan – Hospital Contracting in Today’s Marketplace Statement of Bradley C. Strunk FTC/DOJ.
ASPECTS AFFECTING THE HOSPITAL OPERATION Financial Financial Operational Operational Administrative Administrative Clinical Clinical Safety Safety.
THE COMMONWEALTH FUND Figure 1. Three-Fourths of Health Care Opinion Leaders Think Increased Transparency Is Important Source: Commonwealth Fund Health.
Does Pharma Threaten the System’s Sustainability? September 14, 2015 Bill Barcellona, Sr. VP.
The Big Issues: Palliative Care Perspective MONICA BRANIGAN, MD, MHSC CHAIR, CANADIAN SOCIETY OF PALLIATIVE CARE PHYSICIANS WORKING GROUP ON HASTENED DEATH.
Medicaid & Deficit Reduction Tony McCann. Aggravating Factors - Revenues Alternative Minimum Tax Taxes as a % of GDP 1/20/2016Page 2.
Is drug pricing a problem? PHILIP J. SCHNEIDER MS, FASHP, FASPEN, FFIP PROFESSOR AND ASSOCIATE DEAN UNIVERSITY OF ARIZONA COLLEGE OF PHARMACY PHOENIX BIOMEDICAL.
Health Reform: The Role of Chronic Care and Primary Prevention Kenneth E. Thorpe, Ph.D. Robert W. Woodruff Professor and Chair Department of Health Policy.
Problems Due Thursday, September 27. A Simple Model Goods Where: M = Medical care w/ price p m z = all else w/ price 1 r = insurer’s share of payment.
Office of the State Comptroller Healthcare Policy & Benefit Services Division Retiree Health Office of the State Comptroller Healthcare Policy & Benefit.
Universal Health Care without Private Health Insurance? Single Payer: The Only Affordable, Lifelong, Comprehensive, Quality Health Care Plan for Every.
Slides for Class 10: Traditional Economic Model That Depicts a Firm’s Output Problems With the Traditional Model The Implications These Problems Raise.
Drug Formulary Development & Management
Technology, Information Systems and Reporting in Pharmacy Benefit Management Presentation Developed for the Academy of Managed Care Pharmacy Updated: February.
Bundled Payments for Care Improvement (BPCI) Alliance for Health Reform Capitol Hill Briefing Jim Garnham Dir. Contracting & Payment Innovation.
MEDICARE PART B DRUG PAYMENT PROPOSAL Proposed CMS Rule Cuts Reimbursement For Physician- Administered Drugs Costing More Than $480/Day Projected Effect.
Nonprofit organization initiated by Caterpillar and OSF HealthCare System in 2006 Quality Quest for Health Employers Providers Insurers Policy Makers Consumers.
HCA 497 Week 3 DQ 2 Financial Effects of Governmental Regulations Check this A+ tutorial guideline at ASH/HCA-497-Week-3-DQ-2-Financial-Effects-of-
HCS 455 Complete Class HCS 455 Health Care Policy The Past and the Future - Version 3 To purchase this material click below link
Virtual integration involves contractual links between HMOs and physician groups, hospitals, and other provider units. Source: How Health Care Is Organized—II:
Health Insurance Pricing
An Economic Perspective
National Medicare Prescription Drug Congress
US Prescribers and Biosimilars Naming
HSC 3015 Enthusiastic Study/snaptutorial.com
Value Based Contracting in Action
The Budget is all about Priorities…
Budget Proposals Have Myriad Effects on the Industry
Policy Making for Health Care, the Environment and Energy
Most leaders support competitive bidding for medical equipment prices and negotiation of drug prices by Medicare. “Medicare is the largest payer for health.
این دوره شامل: تعریف مذاکره کلمات کلیدی ورودی ها انواع مذاکره
The large majority of leaders support reform options in President Obama’s budget blueprint. “The following is a list of specific policies that have recently.
Express Scripts Exclusions Target 25 Drug Classes
Office of the Vice Chancellor for Administration and Finance
Program Goals. The National Quality Strategy and You: How CMS Quality Measures Affect Policy and Practice.
Spending on Inmate Health Care
Health Strategies Group
Insurance Complexity and Restrictions Create Concerns for Patients and Doctors Adults, 2013 Insurance did not cover as expected/spent a lot of time on.
Presentation Overview
The Future of Biologics in Part D
Cost Benefit Analysis.
Prescription drug prices: Recent trends and opportunities for change
24/7 Virtual Policy & Membership Engagement System
Policy Options and Distribution of 10-Year Impact
Is A Public Plan A Necessary Part of Health Reform?
Kirby Bessant Vice President, Consumer Programs
Physicians Are More Satisfied with Private Insurers Than Medicare and Medicaid on Payment and Administrative Burden Among physicians: In general, how would.
Payment System Options
Biosimilar Regulatory Issues
Washington Experts, Influencers, and You
Requiring Medicare recipients to participate in an all-payer database for research, policy development, and monitoring and evaluation purposes “How strongly.
VIRGINIA BOARD OF EDUCATION Model Guidance for Positive and Preventive Code of Student Conduct Policy and Alternatives to Suspension
Pharmacy Benefit Manager
Variation Across Payers

Presentation transcript:

Direct Medicare Price Negotiation is Good for Payers 4/15/2019 Health Strategies Group Direct Medicare Price Negotiation is Good for Payers Reducing the biologic exclusivity period would have negative effects on physicians autonomy as payers are likely to require physicians (via tier placement or utilization restrictions) to prescribe lower-cost generic or biosimilar alternatives when available. According to plans, all of the most likely proposals from the administration, Capitol Hill, and states will have positive effects on the value of care provided–a clear priority for most policy makers in the past several years.