Thoughts
Thought Leadership Posts
Making Prescription Drugs Affordable: Options for the Center for Medicare and Medicaid Innovation

CMMI’s statutory directive to test models that improve health outcomes, quality, or costs makes the agency a natural partner in this effort. In addition, CMMI’s recent focus on increasing health care affordability aligns with the administration’s focus on lowering Medicare beneficiaries’ copayments for prescribed drugs, which often depend on their list price rather than the net price. The latter includes manufacturer rebates and is the price that payers pay for drugs. Below, we review a range of approaches CMMI could consider in order to reduce drug spending that include: 1) new models, 2) revisiting previous proposals, and 3) adjustments to existing models...
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What Recent State Elections Mean For Health Care

While most eyes focused on control of the U.S. Congress and, in our world, what that means for health policy, a wide array of election outcomes at the state level will have a meaningful impact on access and care delivery for many years to come. Here we examine changes to state health policy in some key domains: Medicaid, access to abortion services, and health care costs. With Washington DC facing two years of legislative gridlock, implementation of these state-level developments – and new ones assuredly to come – will likely have as big of an impact on the quality of care that Americans receive than anything coming out of D.C....
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To Promote Equity, Include These Key Provisions In Upcoming Nutrition Legislation

Federal nutrition programs reduce food insecurity and are critical to the health and well-being of one in four Americans each year, including nearly one in three children younger than five. These programs are especially important in the wake of COVID-19. Before the pandemic, food insecurity was higher among households near or below the poverty line, households with children, Black and Latino households, and households in large cities or rural areas. The pandemic increased food insecurity and other measures of food hardship, especially for Black and Hispanic households....
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President Biden’s Executive Order Protecting Access to Reproductive Health Services

Two weeks following the Supreme Court’s Dobbs decision overturning Roe v. Wade, President Biden released an executive order (EO) mapping his administration’s planned response. The EO directs the U.S. Department of Health and Human Services (HHS) and other federal agencies to undertake actions to protect health care service delivery and promote access to reproductive health care services, including contraception and abortio...
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What Is Congress Doing to Advance Behavioral Health Reform?

In light of the well-documented mental health and substance use crisis and the exacerbating effects of the COVID-19 pandemic, congressional policymakers are considering a range of behavioral health policy reforms....
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Avoiding the Cliff: Medicare Coverage of Telemental Health and the End of the PHE

The end of the COVID-19 public health emergency (PHE), currently scheduled for April 16, will affect the continuation — or expiration — of temporary Medicare flexibilities, including the expansion of telehealth. During the pandemic, Medicare beneficiaries have had access to a wide range of telehealth services, including telemental health, and uptake has increased substantially. Unfortunately, once the PHE ends, the authority for these flexibilities will no longer be in effect, meaning that many beneficiaries will lose access to services. Federal action to temporarily extend the current telehealth waivers would allow policymakers time to study whether they should make permanent changes regarding telemental health care coverage....
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Bolstering the Public Health Infrastructure in the Wake of COVID-19

The COVID-19 pandemic has highlighted the impact of the chronic underfunding of the U.S. public health system. Despite research showing that investing in public health leads to better outcomes and calls for greater investment in public health, per capita spending before the pandemic totaled less than 3 percent of total health care spending. Here we describe federal policies currently under consideration as part of the Build Back Better Act (BBBA) that could address these concerns....
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Key Provisions of Drug Pricing Proposals

As federal attention begins to turn again to the cost of prescription drugs, the 117th Congress has introduced and reintroduced a number of bills aimed at drug pricing reform. The provisions included in the current slate of bills mirror those that appeared in the previous legislative session, and would seek to reduce drug prices by enacting changes along the following dimensions: Drug price negotiation; Medicare Part D redesign; Medicare Part B and Part D inflation rebates; international mechanisms; generic drug promotion and anticompetitive behavior; and manufacturer reporting....
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Prospects for Drug-Pricing Reform Under a Biden–Harris Administration

The Biden administration has put forward a new slate of policy priorities, but one remains from the prior administration: prescription drug pricing. Despite many attempts, the Trump administration largely failed to deliver sweeping drug-pricing reform. President Biden has set out to enact similar reforms for lowering drug costs and can capitalize on a Democratic majority in Congress. However, the administration may need to rely on a patchwork of policies, rather than comprehensive legislation to rein in drug prices....
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Support for States’ COVID-19 Response Efforts in the American Rescue Plan

On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (ARP) (P.L. 117-2) — the latest COVID-19 relief package and first one enacted by the current administration. Committing nearly $1.9 trillion, the law provides relief to American families that have lost jobs or lack affordable health insurance coverage during the pandemic. It also provides significant funding for states’ pandemic response efforts — something missing from previous relief measures — and for Medicaid programs....
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