National Health Expenditure Report Shows We Have Not Solved the Cost Problem

December 10, 2017

For the third consecutive year, national health spending has outpaced economic growth. The latest update from the Centers for Medicare and Medicaid Services (CMS) finds that national health expenditures (NHE) rose 4.3 percent in 2016, 1.5 percentage points faster than growth in gross domestic product (GDP). Although health spending has slowed considerably since 2002, the latest figures confirm that provisions of the Affordable Care Act (ACA) intended to moderate the pace of rising costs in the health system have yet to show a substantial and sustained impact.

via National Health Expenditure Report Shows We Have Not Solved the Cost Problem

Biosimilar Cost Savings in the United States Initial Experience and Future Potential

December 7, 2017

This Perspective estimates potential future savings from biosimilars in the United States, summarizes the experience to date with the first marketed biosimilar in the United States, and discusses key policy issues surrounding biosimilars. We estimate that biosimilars will reduce direct spending on biologic drugs by $54 billion from 2017 to 2026, or about 3 percent of total estimated biologic spending over the same period, with a range of $24 to $150 billion. While our estimate uses recent data and transparent assumptions, we caution that actual savings will hinge on industry and regulatory decisions as well as potential policy changes to strengthen the biosimilar market.

via Biosimilar Cost Savings in the United States: Initial Experience and Future Potential | RAND

Study: ObamaCare bills backed by Collins would lower premiums

December 6, 2017

Two bipartisan ObamaCare fixes being pushed by GOP Sen. Susan Collins (Maine) would reduce premiums by 18 percent in 2019, according to a new study.

The study from Avalere, a consulting firm, finds that the two bills would more than cancel out the projected premium increase from repealing ObamaCare’s mandate that most individuals purchase health insurance.

via Study: ObamaCare bills backed by Collins would lower premiums | TheHill

CMS Office of the Actuary Releases 2016 National Health Expenditures

December 6, 2017

In 2016, overall national health spending increased 4.3 percent following 5.8 percent growth in 2015, according to a study by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS) published today as a Web First by Health Affairs. Following Affordable Care Act (ACA) coverage expansion and significant retail prescription drug spending growth in 2014 and 2015, health care spending growth decelerated in 2016. The report concludes that the 2016 expenditure slowdown was broadly based as growth for all major payers (private health insurance, Medicare, and Medicaid) and goods and service categories (hospitals, physician and clinical services, and retail prescription drugs) slowed in 2016.

via CMS Office of the Actuary Releases 2016 National Health Expenditures

Obamacare Hikes for 2018 May Top 80 Percent in Some States 

November 19, 2017

Your premiums are going to go up in 2018. The national-average increase is a smidge over 27 percent, but depending on the state you live in, the hike could skyrocket to as much as 81 percent. Freedom Partners has created a state-by-state 2018 “Premium Increase Tracker”.

Read more

Free Birth Control from the Third-Party Trap – Morning Consult

September 3, 2017

As is the case with doctor, hospital and lab bills, the presence of a third-party payer results in higher prices for prescription drugs than would otherwise be the case if a pharmacy dealt directly with the patient. That’s because the third-party payer system severs the direct link between the consumer and the producer of goods and services that allows market forces to work. Doctors, hospitals, labs and pharmacies negotiate with a deeper-pocketed third party, not the consumer, to arrive at a price.

A March 2017 Consumer Reports interview with University of Minnesota professor of pharmacoeconomics Stephen Schondelmeyer summarizes the problem. Pharmacy retail chains are more concerned about what third parties such as insurers will pay, rather than what customers themselves can afford. They focus on setting high list prices to ensure that insurers don’t cut into their bottom line.

Source: Free Birth Control from the Third-Party Trap – Morning Consult

Blue Cross to end “grandfathered” health insurance in NC | News & Observer

August 22, 2017

Thousands of North Carolina residents have been exempt from the Affordable Care Act and got to keep their old health insurance, paying significantly less for their coverage than those insured under the ACA.

But that’s about to come to an end for 50,000 customers of Blue Cross and Blue Shield of North Carolina. In 2018, they will have to switch to ACA plans, in some cases paying twice as much or more for health insurance.

Source: Blue Cross to end “grandfathered” health insurance in NC | News & Observer