HA 415 Unit 5 Discussion

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Kaplan University *

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415

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Health Science

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Feb 20, 2024

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How can health policy reduce health care spending while still supporting the delivery of healthcare services? Good evening, Many different health policies can help reduce healthcare spending, while still supporting the delivery of healthcare services. What I want to focus on is promoting meaningful transparency of price and cost-sharing. The first way to help reduce healthcare spending is to provide tools that will help people better understand their insurance coverage when it comes to services that are provided for them, thus allowing them to make more informed decisions(Howerton,2021). The next part would require drug manufacturers or organizations to report accurate information that will show documents on why price increases are justified for medications, services, or supplies(Howerton,2021). Also, to expand the Medicaid and Medicare reporting of drug costs and spending to help make cost-containing strategies and help drive informed actions by policymakers. Finally, we must ensure all cost savings to a plan or pharmacies can benefit from rebates or other negotiated rates. Doing this hopefully lowers the out-of-pocket costs for patients across the board. Howerton, C. (2021, October 8). Policy recommendations for reducing health care costs . National Health Council. https://nationalhealthcouncil.org/additional-resources/policy- recommendations-for-reducing-health-care-costs/ 1. Promote meaningful transparency on price and cost sharing.  Provide enhanced tools for patients to understand insurance coverage of products and services (including cost sharing) to drive informed action at crucial points of decision making, such as at the time of plan selection (through improvements to Medicare Plan Finder and/or HealthCare.gov), at the time of prescribing, and/or at the time of treatment decisions (such as by building on changes made by Congress and CMS to advance real-time benefit tools).  Require manufacturers to report meaningful information and disclose supporting documentation needed to justify price increases for drugs, biologicals, and biosimilars. Reported information includes but is not limited to:  A narrative of factors contributing to the drug’s pricing;  Information demonstrating comparative patient value;  Acquisition information if the drug was not developed by the current manufacturer;  Aggregate research & development expenditures; and  Aggregate rebates, discounts, and other concessions that reduce the effective price.  Expand CMS’ reporting on drug costs and spending, including price concessions and rebates, to help inform cost-containment strategies and drive informed action by health care stakeholders.

 Create a mechanism to ensure some or all cost savings to a plan/pharmacy benefit manager resulting from rebates, fees, and/or any other negotiations and price concessions are passed through to the patient, such that patients have lower OOP costs for drugs that have greater rebates. The NHC looks forward to working with patients, health care stakeholders, and policymakers to advance the policy recommendations listed above to ensure better health care access and lower costs for patients. [1] Any policy that requires additional FDA staff must include additional agency funding.

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