Congress will be out of town this week due to the impending Thanksgiving holiday. Here is a link to the Week in Congress’s report on last week’s activities on Capitol Hill.
Following up on last weeks’s good news on improvements to electronic health record interoperability, Health Payer Intelligence reports that
The health information network Surescripts is using data from both payers and PBMs to give prescribers access to patient-specific and formulary-based benefit and cost information for nearly three-quarters of all covered lives in the country.
At theI point of care, there have been 30 million views of this data which is integrated within electronic health record technology via the Surescripts Network Alliance’s Real-Time Prescription Benefit tool, the organization stated midweek.
EHR vendors representing 77 percent of the market have signed on at this point, including Allscripts, Cerner, and Epic Systems.
Healthcare Dive tells us about a recent Blue Cross Blue Shield Association study on prescription drug costs.
Insurers under the Blues’ umbrella, dozens of independently run payers, spent about $100 billion on prescription drugs in 2017, roughly 20% of plans’ overall healthcare spending. The figure is 2% higher than it was in 2016, continuing a trend of consistent increases in drug spending since 2010. While generic drugs accounted for 83% of total prescriptions, branded drugs were 79% of total drug spending at $79.5 billion last year.
“…Drug companies raising their prices and offsetting them with higher rebates benefits everyone but the consumer, who routinely pays out of pocket based on list price,” Caitlin Oakley, a department of Health and Human Services spokeswoman, wrote in a statement to USA TODAY. “President Trump and Secretary Azar remain committed to lowering drug prices and reducing out of pocket costs, and will continue to take bold action to restructure this broken market.”
The Wall Street Journal reported last week that Walmart, which has 1,500,000 employees in the U.S.,
said it will require its employees to use certain hospitals for costly spine surgeries, an effort to weed out unnecessary procedures and lower its health-care spending.
The retailer has been trying since 2013 to encourage employees to undergo the surgeries at hospital systems known for their quality by offering to pay the full cost of the procedures and travel. But not all workers took Walmart up on the offer, and the retailer continued to pay for surgery elsewhere.
Walmart decided to mandate the travel, starting in January, after finding that half of the workers who volunteered to travel ended up avoiding the high-cost surgery even though their local doctors said it was needed, said Lisa Woods, who oversees the design of the company’s health plan. * * *
The retailer decided to mandate spine surgeries at certain well-regarded hospitals, such as Mayo Clinic’s around the U.S., Geisinger’s in Pennsylvania and Memorial Hermann Health System’s facilities in Texas, after finding employees who volunteered to travel to the hospitals avoided unnecessary procedures and Walmart saved money, Ms. Woods said.