The Health Policy War Room

In an ongoing effort to address the healthcare needs of Americans, Senator Bernie Sanders has introduced the Medicare for All 2023 Bill. This proposed legislation aims to transform the United States healthcare system by providing comprehensive healthcare coverage to all residents, regardless of their age, income, or employment status. Versions of Medicare for All have been introduced in some version since at least 2019 and the concept of single payer health reform has been around for decades. This version of the single payer proposal has 15 sponsors including Mr. Sanders, Ms. Warren (no relation), Mr. Booker and others and reportedly has upwards of 112 co-sponsors. While this level of support does not guarantee that the bill survives, it does demonstrate that Congress is taking health reform seriously and is willing to float various ideas designed to reform and improve the healthcare system. Image created by AI via http://www.gencraft.com Let's delve into the key provisions and obj

Recently, much has been written about the escalating costs of drug prices in the US. Increasing drug prices are present challenges to those who struggle with affordability and access to their medications. The Inflation Reduction Act brought changes to the way the Medicare program reimburses for prescription drugs. Last year, President Biden challenged the Center for Medicare and Medicaid Innovation (CMMI) to develop and test new payment models that can support value-based payments and promote high-quality healthcare. CMMI has recently proposed three models intended to improve affordability and access to drugs as well as measuring the feasibility of implementation.       1. The Medicare High-Value Drug List Model Under this model, Part D plans would be encouraged to offer a low, fixed co-payment across all cost-sharing phases of the Part D drug benefit for a standardized Medicare list of generic drugs that treat chronic conditions. Patients picking plans that participate in the Model wi

The Centers for Medicare & Medicaid Services (CMS) recently issued an update on its hospital price transparency enforcement efforts. This update is part of the agency's larger goal to increase transparency and empower consumers to make informed healthcare decisions. Under the new rule, hospitals that fail to comply with the transparency requirements will face penalties of up to $300 per day, and the CMS will also publicly disclose the names of non-compliant hospitals. This move is a significant step towards holding hospitals accountable for providing accurate and easily accessible pricing information to their patients. The CMS's update is a much-needed move towards transparency in the healthcare industry. It's no secret that medical bills are often complicated and difficult to understand, leaving many patients feeling helpless and vulnerable. By mandating that hospitals provide clear pricing information, patients will have the tools they need to make informed decisions

Medicare is an important aspect of the healthcare system in the United States and plays a crucial role in providing medical coverage to millions of seniors. In recent years, Medicare spending and financing has been a topic of great concern and debate, with many questioning the sustainability of the program. In this article the Kaiser Family Foundation takes a look at some trends in Medicare spending and financing and what policy solutions might address these concerns. In 2020, Medicare spending accounted for 3.7% of the Gross Domestic Product (GDP), and this number is expected to grow in the future. KFF projects that Medicare spending will reach 5.8% of GDP by 2040. The main drivers of this spending growth are the increasing number of beneficiaries, rising healthcare costs, and the increasing costs of new medical technologies. This trend highlights the need for finding solutions to reduce the growth of healthcare costs and improve the efficiency of the healthcare delivery system. With

 Earlier this week, HHS issued a press release announcing key dates for the first year of the Medicare drug price negotiation process. The Inflation Reduction Act provided Medicare with the authority to negotiate prices for a select number of prescription drugs. These negotiated prices will go into effect in 2026. HHS and the Centers for Medicare and Medicaid Services have committed to providing the opportunity for stakeholders to be engaged in the negotiation process by providing the opportunity for public feedback collection. According to CMS, they will be actively soliciting feedback on areas including: Terms and conditions contained in the manufacturer agreement, including the manufacturer’s and Secretary’s responsibilities. Approach for considering  the manufacturer-reported data elements and  evidence about alternative treatments.  Process for the offer and counteroffer exchange between the Secretary and manufacturers.  Content of an explanation for the maximum fair price.  Meth

 Last week, the FDA's Center for Drug Evaluation and Research released it 2021 report of New Drug Therapy Approvals. The approvals are notable for the potential to provide a positive impact on patient care. The following infographic shows some of the more notable statistics from this year's report. According to the FDA, CDER approved 50 new drugs in 2021. The applications represented both new molecular entities under New Drug Applications or new therapeutic biologics under Biologics License Applications. In each case, the active ingredient or ingredients have never been approved in the U.S.  New drugs advance treatment options in heart, blood, kidney and endocrine disease; autoimmune, inflammatory and lung diseases; infectious disease; neurological and psychiatric disorders; cancer; and other orphan conditions. 98 percent of the approvals were granted within the Prescription Drug User Fee Act timeframes and nearly 90 percent were approved on the first cycle. The FDA credits thi