April 2018 Conference Updates

Posted April 5th, 2018 by Be The Match and filed in Payer Policy
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Executive Recap: AHIP Health Policy Conference in Washington D.C. March 6-8

This year’s National Health Policy Conference, held in Washington D.C. by America’s Health Insurance Plans, was an event for the ages!  The conference featured speakers and panelists well-known and influential in the health industry, including the HHS Secretary Alex Azar, FDA commissioner Scott Gottlieb, former CMS Director and IHI President Don Berwick, and many others.  Our team sent several staff who obtained insights as to what the various stakeholders are implementing when it comes to the federal and state health policy, internal operational/policy changes, and payer trends and initiatives to provide value based care.  Below is a summary of key points or trends that will impact access to cellular therapies for your consideration:

  • Value Based Insurance Design (VBID) holds promise for payers to provide true value by eliminating out of pocket costs for high value services. For example, CVS removed co-pays on both generic and brand name drugs.  This helped drive utilization to high value care.
  • Kenneth Burdick, CEO of Wellcare Health Plans, Inc. stated that 80-90% of prior authorizations will be removed from the company’s processes resulting in a better experience for their members.
  • CMS actuaries said high deductible health plans have helped control costs, so employers will continue to expand their use now and into the future.
  • Kavita Patel, Brookings Institution fellow and Johns Hopkins internist, stated that many oncology providers do not know the cost of pharmaceutical drugs for their patients, yet medication adherence and thus outcomes are driven by affordability of drugs according to a recent study in JAMA.
  • Technology is critical in the transition to value-based care, and as the amount of data payers have on their customers increases, opportunities for sharing information with providers will allow for shift to value-based payment arrangements.
  • Drug pricing affordability is an issue and patients need to be included in these conversations and be allowed transparency in pricing and benefits.
  • Social determinants of health framework is here to stay and payers are expected to navigate patients to resources. The National Marrow Donor Program (NMDP)/Be The Match ® has a variety of support programs to help you provide access to transplant and remove social barriers for your members.

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