Federal Transparency Rule Announced at V-BID Center; Medicare Offers COVID-19 Antibody Treatment with No Cost-Share
CENTER UPDATE | Early DECEMBER 2020
This update features policy developments, media reports, and events supporting continued momentum for multiple V-BID Center initiatives throughout late November and early December.
Federal Rule Directs Insurers to Reveal What They Pay for Prescription Drugs
A new Trump administration rule, part of a broader transparency rule announced at the V-BID Center on October 29th, 2020, will require health plans to provide customers with estimated out-of-pocket costs for prescription drugs and disclose negotiated prices for drugs. The new rule will help patients in private health plans and their physicians choose less expensive medications, which could boost medication adherence and improve health outcomes.
CMS Takes Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment
On November 10th, 2020, the Centers for Medicare and Medicaid services announced that Medicare beneficiaries can receive coverage of monoclonal antibodies to treat COVID-19 with no cost-sharing during the public health emergency. The V-BID principle of reducing financial barriers to essential clinical care has been a consistent theme in the federal government’s, states’ and private payers’ responses to the COVID-19 pandemic.
Five Ways for Policymakers to Continue the Fight Against COVID-19
The Blue Cross Blue Shield Association recently released recommendations for policymakers to address the COVID-19 pandemic. BCBSA stated that future policies and laws must focus on ensuring coronavirus prevention, testing, and no-cost access to a safe and effective vaccine, once it’s available. The statement also called for increased access to affordable care for COVID-19 testing and treatment.
Employee Cost-Sharing in the Medical Expenditure Panel Survey Component 2019 Chartbook
The 2019 Medical Expenditure Panel Survey revealed that the proportion of health insurance enrollees with a deductible increased from 66.4% in 2006 to 86.6% in 2019. As of 2019, 55.3% of individual enrollees and 53.5% of family enrollees were enrolled in high-deductible health plans. Increased exposure to HDHPs may lead beneficiaries to forego necessary care due to out-of-pocket costs, potentially leading to poorer health outcomes and higher overall costs.
Despite ACA Coverage Gains, Millions Still Suffer 'Catastrophic' Health Care Costs
New research found that approximately 11 million Americans experienced catastrophic medical expenses in 2017. Low-income, privately insured people had the highest rate of catastrophic health care spending. Despite gains in insurance coverage following the Affordable Care Act, many Americans are still vulnerable to high levels of cost-sharing, especially if they are enrolled in high-deductible health plans.
Help Cut Burdens of High-Deductible Health Plans
The American Medical Association has adopted new policies to mitigate the negative impacts of high-deductible health plans. The policies encourage ongoing research, advocacy, and collaboration to develop innovative health plan designs, including clinically-nuanced benefit designs. The AMA also encourages employers to tailor health insurance plans to the preferences and needs of their employees.
PBGH Survey: Nearly Sixty Percent of Employers Prioritizing Reducing Health Care Costs in 2021
The results of a poll conducted by the Pacific Business Group on Health indicate that nearly 60% of employers prioritize reducing health care and prescription drug costs in 2021. To reduce costs, employers plan to alter drug formularies to eliminate wasteful spending, engage in value-based contracts, and invest in methods to address inequities in care delivery and outcomes.
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