Five Reasons Why Drug Rebates Are Harmful to Patients and to the Healthcare System

Ever-larger rebates are distorting the market for branded drugs and producing outcomes that often benefit neither consumers nor the healthcare system, according to a new study published by Pioneer Institute. 

Analysis of Spending on Shoppable Services in Massachusetts

This report reveals that consumers in just one Massachusetts county could have saved nearly $22 million in a single year and $116.6 million adjusted for inflation over four years if they switched from using the most expensive providers for 16 shoppable healthcare services to those whose prices were closer to average.

Open Letter: COVID-19 Study and Recommendations Task Force established pursuant to Massachusetts Bill H.4672

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Recently, Governor Baker signed legislation, H. 4672, that would create a Covid-19 task force, appointed by the legislature,  to study and make recommendations to the general court that address health disparities among certain populations based on certain characteristics, including age, and which also asks the future task force to recommend other impacted populations for further study.  Pioneer has prepared a public letter to that future task force that contains a list of specific recommendations regarding Covid-19 and the state’s nursing homes. 

The Negative Impact of COVID-19 Upon the Biopharmaceutical Sector

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Contrary to conventional wisdom that says the coronavirus pandemic will generally benefit biopharmaceutical companies, a new Pioneer Institute study finds many companies will emerge from the pandemic commercially weaker, dealing with delays in new product launches and with fewer resources to invest in research and development.

Status of Healthcare Price Transparency across the United States

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At a time when the coronavirus pandemic has caused massive shifts in state policies on telehealth and scope of practice in healthcare, a new Pioneer Institute study underscores that most of the 50 states continue to suffer from weak laws regarding price transparency.  The study identified states that have laws that require carriers, providers or both to provide personalized cost information to consumers before obtaining healthcare services.

The Massachusetts Crises Of Care Guidelines Need Re-Thinking

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This new study contends that the Massachusetts Department of Public Health’s (DPH’s) Crises Standards of Care (CSC) issued earlier this month bear the earmarks of a state bureaucratic effort. The guidelines need to be rethought under a process that includes a thorough vetting by Massachusetts citizens.

Massachusetts Consumer Healthcare Price Transparency Survey

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This public opinion survey, conducted by renowned pollster David Paleologos, Director of Suffolk University’s Research Bureau, focused on consumers’ view of healthcare price transparency. The poll showed that consumers want to know the price of care before obtaining it, and identified opportunities to improve consumers’ search for high-value, low-cost healthcare services. 

Looming Challenges for ICER in Assessing the Value of Rare Disease Therapies

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This report examines why the Institute for Clinical and Economic Review (ICER) and the Quality Adjusted Life Years (QALY) approach to value assessment is particularly ill-suited to assess the cost-effectiveness of orphan and rare disease treatments, which represent a rapidly growing sector of the biopharmaceutical marketplace.

Wildly Varying MRI Prices at Massachusetts Hospitals: Why We Need Access to Healthcare Prices at All Levels

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New study finds there is little correlation between a patient’s out-of-pocket cost and either the amount insurers pay or the overall price of a procedure at 14 representative Massachusetts hospitals.

Key Questions for Legislators on the Institute for Clinical and Economic Review (ICER)

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As states continue to grapple with prescription drug costs, a new Pioneer Institute study lays out the key ethical, methodological and disease-specific questions policy makers should address before deciding whether to contract with the Institute for Clinical and Economic Review (ICER) to conduct cost effectiveness reviews used to make decisions about the purchase of medicines and other medical innovations.

MassHealth Protecting Medicaid Resources for the Most Vulnerable

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This report finds that Massachusetts' enhanced eligibility verification has allowed MassHealth, the Commonwealth’s Medicaid program, to save significant resources that could be redirected to the care of truly needy Medicaid recipients.

Will New England See Lower Prices from Drug Pricing Transparency Legislation?

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This report finds that most new drug pricing transparency laws do not lower consumer out-of-pocket costs, and that expensive and onerous compliance rules would likely put upward pressure on prices. The report reviews recent New England legislative attempts to reduce costs by requiring the disclosure of wholesale drug prices and other information about industry pricing practices.

Need an MRI? In Worcester, Patients Pay Less for More

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Data from the Massachusetts Center for Health Information and Analysis (CHIA) show wide variations in the prices agreed to between individual insurers and providers, the portion paid by insurers and the amount that is consumers’ responsibility to pay.

MA Health Insurers Have Improved Their Consumer Price Transparency Efforts, But Significant Work Remains

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This study finds some significant improvements in the online cost estimator tools created by Massachusetts’ three largest health insurers, but there is much still to be done for the carriers to maximize the opportunity price transparency represents.

Recommendations of Pioneer Institute to the Special Senate Committee on Health Care Cost Containment and Reform

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Jim Stergios, on behalf of the Pioneer Institute, provides public…

Testimony in Support of Expanded Access to Oral Health

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There is a bill before the Massachusetts Legislature seeking to expand access to dental care through the creation of a mid-level provider position, commonly known as a dental therapist.

Dialing up Telemedicine

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Massachusetts should more aggressively embrace telemedicine, which can reduce healthcare costs, increase patient satisfaction, and is more convenient for both patients and physicians.

What Massachusetts Should Do in an Uncertain Healthcare World

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Regardless of what happens in the debate over repealing and replacing the ACA in D.C., Massachusetts has to tackle health care costs intelligently. We need to do more than provide insurance; we need to increase access to care. That means thinking seriously about the role of private market insurers, insurance regulations and the regulation of medical providers.

Lowering the Healthcare Cost Growth Benchmark

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This policy brief applauds the decision by the Commonwealth of Massachusetts's Health Policy Commission to allow the benchmark for increases in the overall rate of healthcare spending to decrease this year, but urges state policy makers to remain focused on the larger culture changes that will be needed to rein in healthcare costs.

Counter Point What Massachusetts Should Do As Uncertainty Engulfs US Healthcare System

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Regardless of what takes place at a national level, Massachusetts has its own set of challenges to continue pursuing the state’s commitment to universal coverage at affordable prices. This report offers a ten-point program that the state should vigorously focus on in the days ahead.

Massachusetts Hospitals Score Poorly on Price Transparency…Again

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Eighteen months after an initial survey of prices at hospitals in Massachusetts, Pioneer Institute conducted a follow-up survey of all but one of the hospitals from the first survey to see if there had been any change in the performance of these institutions since their last assessment. Initial survey calls were conducted between September 20th and November 2nd, 2016.

Recommendations to the Transparency Subcommittee of the Special Commission on Provider Variation

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Submitted to the Special Commission on Provider Price Variation on January 31, 2017

Testimony on Healthcare Price Transparency

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Testimony emphasized the need to focus more on what would help consumers make better decisions about spending on healthcare.

Transparency in Retail Drug Prices: Easy to Obtain but Accuracy May Be Doubtful

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This paper is the fourth in a series on price transparency in the healthcare industry, and the first Pioneer report to focus on the retail price of prescription medications. Researchers called 44 retail drug stores across the state asking for the price of a 30-day supply of each drug in a common dosage. In each case the callers said they were self-pay and pressed the drug store for information about discounts.

Over A Decade, The ACA Fee On MassHealth Will Cost Hundreds Of Millions Of Dollars

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In “Over a Decade, the ACA Fee on MassHealth Will Cost Hundreds of Millions of Dollars,” authors Lauren Corvese and Josh Archambault examine the potential budget impact of the Health Insurer Provider Fee (HIPF), a revenue-raising mechanism for the Patient Protection and Affordable Care Act (ACA).

Combating Opioid Addiction in Massachusetts: A Hospital-Based Solution Shows Promise in Reducing Relapses and ER Costs

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Preliminary results suggest that a new program that gives opioid overdose patients at Beth Israel Deaconess Hospital-Plymouth (BID-Plymouth) multiple opportunities to access detox programs, psychological counseling, anti-abuse drugs and other services is proving effective at reducing recidivism and returning opioid users to more productive lives.

Are Drug Prices Driving Healthcare Cost Growth?

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This report illustrates that state policy and legislative recommendations requiring pharmaceutical companies to disclose proprietary information would discourage the development of new innovative medicines, lead to higher healthcare costs over the long term, and potentially damage a big driver of Massachusetts' business economy.

Healthcare Prices for Common Procedures Are Hard for Consumers to Obtain Survey finds hospitals not prepared to give price information to consumers

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This policy brief is the third in a series of reports on healthcare price transparency prepared by Pioneer Institute. Researchers surveyed six major metropolitan areas and spoke with 54 acute care hospitals across those regions: Des Moines, IA, Raleigh-Durham, NC, Orlando, FL, Dallas-Ft. Worth, TX, New York, NY and Los Angeles, CA asking for the price of an MRI of the left knee without contrast. In addition, they explored the existence of federal and state laws that might apply in the states where the hospitals surveyed are located. They also examined the websites of the 54 hospitals for price information. The results of this survey are described in this policy brief.

What Will U.S. Households Pay for Health Care in the Future

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This white paper reports that health care costs for a U.S. family of average income (including family insurance premium contributions and out-of-pocket costs including co-payments, coinsurance and deductibles) could increase from $8,583 annually to $13,213 by 2025, but up to as high as $18,251 in the same year. In terms of proportion of earnings, this would be equivalent to 20 percent and 27 percent of household income by 2025, respectively.

Bay State Specialists and Dentists Get Mixed Reviews on Price Transparency

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Pioneer surveyed 96 specialists from across Massachusetts, split…