JustCare

Tag: Transparency

  • New California law forces Pharma to justify price hikes

    New California law forces Pharma to justify price hikes

    Kaiser Health News reports that last week, California Governor Jerry Brown signed a major drug transparency law for the state. The goal is to help the public get a handle on why it is necessary for pharmaceutical companies to be raising drug prices so much each year as well as to address increasing income inequality. But, unlike the laws in New York and Maryland, the California law does not empower the state to rein in drug prices.

    The law forces Pharma publicly to justify price hikes of 16 percent or more over two years. The law applies to all drugs with a wholesale cost of $40 or more.  Pharmaceutical companies must give state agencies and insurers 60 days’ notice of their proposed price hikes.

    The piece of the law requiring notice to state agencies and insurers takes effect on January 1, 2018. The piece of the law requiring public justification of price hikes does not take effect until 2019.

    The law also requires insurers to report how much of the year’s premium increase is attributable to drug prices.

    Pharma’s response to the law–which drug manufacturers spent millions of dollars and hired 45 lobbyists to oppose–is to point the finger at health insurers and pharmacy benefit managers as the businesses responsible for high drug prices. Drug companies would like to pretend that they are somehow not responsible for the big rebates they pay businesses and insurers to promote their drugs over other often less costly drugs. Pharmacy benefit managers and insurers pocket these rebates, as much as they can, and do not pass them on to patients.

    If you’d like Congress to rein in drug prices, please sign this petition.

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  • Even without ACA repeal, quality of care at risk

    Even without ACA repeal, quality of care at risk

    The Republican leadership’s ACA repeal bill is dead for now, but quality of care in the U.S. is still at risk. In an interview for KPBS.org, Donald Berwick, M.D., president emeritus of the Institute for Healthcare Improvement and former head of the Centers for Medicare and Medicaid Services, explains the importance of ACA initiatives to improve health care quality. Even without ACA repeal, there’s reason for concern that the Trump Administration will give these initiatives short shrift.

    As head of the department of Health and Human Services, Tom Price could do a lot to undermine the quality improvement programs included in the Affordable Care Act.  Will Secretary Price, for example, honor the ACA’s requirement that government collect health care data, develop evidence-based measures of health care quality, and give people a better understanding of differences in care provided by doctors, hospitals and nursing homes? Will the Trump Administration promote health care transparency or leave us in the dark when doctors and hospitals perform poorly, putting patients at risk.

    Beyond supporting systems for measuring and reporting quality of care, what will become of ACA-funded initiatives that promote significant quality improvements among doctors and hospitals? For example, the ACA’s $500 million Partnership for Patients helps reduce hospital-acquired conditions, such as pressure ulcers people get in hospital from not moving, and blood clots. According to Berwick, that initiative alone has saved “tens of thousands of lives and billions of dollars.”

    Similarly, Medicare’s hospital five-star rating system and financial penalties on hospitals that performed poorly on certain quality measures, (for example, hospitals with high readmission rates within 30 days of patients being discharged or with high numbers of patients acquiring infections unnecessarily,) have helped to promote better care. And, they have helped Americans appreciate that some hospitals perform better than others. Will the Administration dedicate needed funds to these programs?

    The Republican leadership has not shown much appreciation for the value of health care transparency and incentives to drive quality improvements. How far backwards will they push our health care system even without ACA repeal?

    Here’s more from Just Care:

  • To promote patient safety, hospitals and doctors should disclose more information

    To promote patient safety, hospitals and doctors should disclose more information

    Transparency in health care can be a powerful tool for ensuring patient safety.  But, it is too often not taken into account when considering patient safety measures.  As a result, serious mistakes may happen in hospital or at the doctor’s office, and no one can learn from them. Or, a medical device, such as an artificial joint may have a design defect, and few people will know not to use it.

    Medicare collects and reports some important patient safety information, including how hospitals rank on two types of avoidable infections and eight different types of avoidable complications such as bed sores and blood clots.  It’s worth looking at this information to see how your local hospitals rank. And, Consumer Reports also offers some patient safety data. That said, there’s a lot of critical information that’s not available to the public.

    The National Patient Safety Foundation’s Lucian Leape Institute is working to promote the benefits of transparency in health care and to demonstrate that the risks are minimal. Its recent report, Shining a Light: Safer Health Care Through Transparency, offers dozens of recommendations for providers on everything from safety data collection, to building a culture of safety, affording patients good information to make informed health care choices, and sharing best practices with other provider groups.

    Transparency is hard to achieve because hospitals and other providers worry about how information that shows medical errors and poor quality can hurt reputation. People also can easily misinterpret some quality measures. For example, patients may be readmitted to the hospital because their condition worsened but people may wrongly assume it was because their care was poor.

    The Leape Institute demonstrates the benefits of disclosing safety information. The data suggests that disclosing medical errors has not increased malpractice suits or cost hospitals more as some may believe. And, one national pediatric hospital collaborative that banded together to identify the biggest harms and stress safety to improve performance were able to reduce serious harm by 40 percent.