The Health Policy War Room

Blood tests and clinical lab tests are vital components of medical care, serving a variety of purposes, from prevention and diagnosis to monitoring various medical conditions. In the United States, these tests are the most common healthcare service, with approximately 14 billion tests ordered annually across 260,000 laboratories. However, recent research has uncovered a concerning trend: hospital outpatient departments are billing private insurance three times more for the same lab tests compared to physician offices and independent laboratories. A study conducted by the Health Care Cost Institute (HCCI) utilized a comprehensive commercial claims dataset to compare prices of clinical lab tests between hospital outpatient departments and physician offices/independent labs. The analysis revealed significant markups for lab tests performed in hospital outpatient departments. The median prices for tests such as lipid panels and comprehensive metabolic panels were three to five times highe...

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...

On June 22, Senator Ron Wyden (D-Ore.), Chairman of the Senate Finance Committee released his own set of “principles” for lowering prescription drug prices. Characterized as a step toward “comprehensive legislation” on the matter, the principles are said to guide Wyden’s work during the summer months with the ultimate goal of delivering relief from high prescription drug prices. Wyden’s principles largely reflect the concepts that have been widely circulated as parts of many prior statements on reducing drug prices. Medicare negotiation, limiting out-of-pocket costs at the pharmacy counter, controlling price increases for older drugs, and rewarding innovation are concepts that have been debated at length in the past. Wyden also suggests that any drug pricing proposals should apply to all Americans – not just those covered by Medicare. Acknowledging the work already done by the Senate Finance Committee, Wyden’s goal is to develop a legislative package, with bipartisan support, that can ...

In this week's Healthcare HotShots, I get in the wayback machine and revisit May 2018 to look at President Trump's American Patients First blueprint to see if I can figure out what a second Trump Administration might do to lower prescription drug costs.

Earlier this week, the Government Accountability Office (GAO) released its latest bimonthly report to Congress on the status of the Federal Response to the COVID-19 pandemic . The GAO reviewed data from multiple sources including USAspending.gov, data obtained directly from agencies, Bloomberg, and other economic research groups. The GAO also developed health indicators that may be useful in continued measurement of response to this and future pandemics. The GAO found that over $2.2 trillion has been allocated for pandemic relief, of which agencies had obligated $1.5 trillion and recorded spending $1.3 trillion. Additionally, GAO found that more can be done to monitor the health care system's response to the pandemic, and they recommended four healthcare metrics that could be used to measure the system's ability to handle and react to emergencies. Finally, the GAO found that the economy is still weak, but appears to be improving with the help of the Federal Pandemic Response. T...