Editorial Staff

Moving the Needle on Healthcare Cost Containment & Reform

/0 Comments/in , , , , , /by Editorial Staff
Share on Facebook
Share on Twitter
Share on
LinkedIn
+

Today, Pioneer Institute submitted recommendations to the Commonwealth of Massachusetts’ Special Senate Committee on Health Care Cost Containment and Reform. Pioneer applauds provisions of the proposed legislation that would reduce emergency room use and re-admissions, expand scope of practice, and embrace telemedicine. The Committee should also be commended for looking to other states’ accomplishments in this area.

But the current bill raises some concerns. In some instances, we believe it diminishes the potential for greater cost savings by adding unnecessary regulatory burdens. The projected savings relative to 2020 spending are quite modest, at less than 0.2 percent. The Medicaid buy-in program as it is presented is a radical change from the existing program structure – it will require more elaboration and analysis, as it is unclear what the impact of this proposal will be on MassHealth and providers across the Commonwealth. Pioneer also has concerns that the bill could lead to harmful unintended consequences, such as the collapse of the merged private insurance market. We hope the Legislature addresses these issues, but this bill starts an important healthcare cost conversation in Massachusetts, and we commend the Senate for taking the lead in this effort. Read Pioneer’s full letter to the Committee.

Get Updates On Our Healthcare Research and Events!

Related Research

First-of-Its-Kind Interactive Mapping Tool Reveals Extent of For-Profit Entities Benefitting from the 340B Drug Pricing Program

Today, Pioneer Institute released a first-of-its-kind, 50-state mapping tool and database highlighting the troubling way in which hospitals and covered entities leverage unlimited pharmacy contracts under the 340B Drug Pricing Program.

Survey Finds Spotty Compliance Among Hospitals with Federal Price Transparency Law

A 2019 federal law requires hospitals to make prices for 300 shoppable services available online in a “consumer-friendly format,” but a Pioneer Institute survey of 19 hospitals finds that information on discounted cash prices—the price most likely to be charged to consumers paying out of pocket—was unavailable at seven of those hospitals.

Harvard research points to ending drug cost help

A common grievance about Harvard is that the university is out of touch with the concerns of everyday Americans. This perception is confirmed by recent research from Harvard Business School that contends patients should be denied assistance that helps them afford their prescription drugs. The Harvard study argues that in order to control drug prices, the government should deny patients’ access to copay assistance programs offered by drug manufacturers. It flies in the face of federal and state efforts to protect the value of such assistance programs for patients and ignores basic facts about how and when patients use copay assistance to access their medications.

Is CHIA’s Drug Cost Data Reliable?

Earlier this year, the Center for Health Information and Analysis (CHIA) released its Annual Report on the Performance of the Massachusetts Health Care System for 2020.  The Massachusetts Legislature relies on CHIA data when considering bills to regulate drug costs and prices. The advocacy group Health Care for All reported that CHIA data showed prescription drug spending grew by 7.7 percent in 2020, more than twice the benchmark - but the most reliable data on prescription drugs indicates that spending in 2020 was essentially flat. 

Is this PBM tactic blocking healthcare access?

Utilization Management (UM) was originally a strategy designed to improve the safety, quality, and cost-effectiveness of physician prescribing. However, UM has grown exponentially over the last decade, becoming more a tactic for Pharmacy Benefit Managers (PBMs) to manage costs to benefit their bottom line.

The Realities Behind US Healthcare Spending

Healthcare policy is an all-encompassing term. It plays a role in every individual’s life; how it is curated, developed, and maintained has a significant long-term impact on the quality of life of any given community. It is critical that policymakers consistently adapt and amend healthcare policies in the ever-changing global pricing and affordability environment while providing funding support for optimal quality of care.

Cures for Patients, Not Health Plan Profits, Make Drugs Valuable

To the astonishment of many observers, the Institute for Clinical and Economic Review (ICER) recently concluded that a $2.1 million gene therapy for a life-threatening blood disorder called beta thalassemia, is priced cost-effectively. The surprise was especially pleasant, given that ICER’s methodology had, in the past, displayed bias against rare disease treatments and undervalued the lives of people living with disabilities.

Healthcare dominates the job market.

0 Comments
/
Healthcare and social assistance are among the most important…

Caution towards CMS Data Sources for Healthcare Legislation

0 Comments
/
Policymakers rely on accurate and timely data when implementing legislation or regulation to address biopharmaceutical spending in the U.S. Based on this research, policymakers may want to utilize other sources in addition to NHE data provided by CMS when making policy recommendations. 
This file is licensed under the Creative Commons Attribution 2.0 Generic license.

Healthcare Employs More on Cape Cod Than Any Other Sector

0 Comments
/
Despite being a major tourist destination, the largest employment sector on Cape Cod is not related to tourism: it is healthcare!

Exploiting Charity Drugs: Hospital Program Earns Billions But Forgets Mission

Hubwonk host Joe Selvaggi talks with Pioneer Institute’s Dr. Bill Smith about his recently released paper entitled, "340B Drug Discounts, An Increasingly Dysfunctional Federal Program," which analyzes the evolution of a well-intentioned program to offer discounted drugs to the uninsured from a benefit that had helped charitable hospitals to one that has exploded to generate billions in profits while serving fewer uninsured.

Massachusetts Hospitals Pull Back on Charity Care as Revenue from Federal 340B Drug Discount Program Explodes

Over the past decade, the revenue for hospitals generated by the federal 340B drug discount program, initially intended to serve low-income, uninsured populations, has exploded even while a number of important Massachusetts hospitals have reduced the level of charity care they provide, according to a new study published by Pioneer Institute. The Pioneer Institute study, “340B Drug Discounts: An Increasingly Dysfunctional Program,” notes that nationwide, 340B drug sales rose from $9 billion in 2014 to $38 billion in 2020.

How did COVID impact Massachusetts’ long-term care facilities?

Pioneer Institute has filed a Public Records Act request related to COVID's impact on Massachusetts’ long-term care facilities because the Institute believes this is a matter of obvious importance, both on principle (the public has a right to know the facts), and for purposes of evaluating – and where possible improving – public policy. 

The Promise and Challenges of Rare Cancer Treatments

Dr. William Smith, Pioneer Institute's Visiting Fellow in Life Sciences, spoke about the challenges and opportunities for rare cancer treatments, in a video interview produced by Rare Cancers, a patient group based in Australia, for the November 26th CAN Forum. 

Study: Decline in Cardiovascular Health Screenings During COVID-19 Pandemic Poses New Public Health Threat

Pioneer Institute today released a new analysis focused on cardiovascular disease, An “Impending Tsunami” in Mortality from Traditional Diseases?, that examines how the COVID-19 pandemic has created another unrelated public health crisis. The Pioneer analysis examines how a single-minded public health focus on COVID-19, social distancing, and lockdowns drove reductions in screenings, diagnoses, and early treatment for complex conditions such as heart disease.

A Modest Proposal to Raise Federal Revenue

As a way to tackle drug prices, President Joe Biden recently announced that he supports the so-called “inflation rebate,” which would require drug companies to give the federal government any revenue from Medicare drug prices above the general rate of inflation. Senate Finance Committee Chairman Ron Wyden and House Speaker Nancy Pelosi have also publicly endorsed the inflation rebate.

Why are health care costs rising every year in Massachusetts?

0 Comments
/
The largest driver is the increase in prices by health systems that have the clout to command higher payments and work to recruit more patients to their high-cost facilities.

Pioneer Institute Statement on the Commonwealth’s Discontinuance of the COVID-19 Weekly Public Health Report

Useful information about COVID cases or deaths at individual homes has become less available at a time when cases are increasing again, even among vaccinated residents. Pioneer urges Massachusetts to immediately reinstate the so-called Weekly Report, which contains cases and deaths inside individual nursing homes.