Cost and Quality

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Latest Morning Briefing Stories

HHS Cracks Down On Drug Companies Taking Advantage Of Loophole In Medicaid’s Complex Payment Structure

KHN Morning Briefing

The new guidance, which officials say will cut back on the companies’ “abusive behavior,” concerns the rebates that drug makers have to pay back to states when a patient receives one of their medicines. In other pharmaceutical news: the administration is preparing to put action behind its rhetoric on drug pricing; some say Medicare’s new negotiating powers could lead to increased hospitalizations; and more.

In Latest Swipe At Health Law, ACO Program That Failed To Save Government Billions Will Be Overhauled

KHN Morning Briefing

Accountable care organizations were set up under the Affordable Care Act with the intention of improving quality and efficiency. But government data shows that they’ve fallen short of the savings that were projected. “After six years of experience, the time has come to put real ‘accountability’ in Accountable Care Organizations,” CMS Administrator Seema Verma said in a statement. “Medicare cannot afford to support programs with weak incentives that do not deliver value.”

Medicare’s Power To Negotiate Drug Prices Will Harm Patients With Chronic Illnesses, Advocates Warn

KHN Morning Briefing

Medicare Advantage’s negotiating tool — requiring patients to try lower-cost treatments before the more expensive ones — is derided as a “fail first” process to those who oppose the strategy. “Consumers may have to go through one or more drugs before they can get a particular treatment they really need,” said Ellen Albritton, a senior policy analyst at Families USA. Meanwhile, there are already signals that implementing the new rules is going to be complicated.