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Dr Steve Miller Weighs Pros and Cons of Medicare Part B Proposal

The new Medicare Part B proposal from CMS has been controversial, and Steve Miller, MD, senior vice president and chief medical officer of Express Scripts, understands both sides of the argument. While he appreciates CMS' dedication to innovation, the demonstration may drive up payer costs.


The new Medicare Part B proposal from CMS has been controversial, and Steve Miller, MD, senior vice president and chief medical officer of Express Scripts, understands both sides of the argument. While he appreciates CMS' dedication to innovation, the demonstration may drive up payer costs.

Transcript (slightly modified)

What is your take on the Medicare Part B demonstration proposed by CMS?

So we actually think there’s both good and bad in what they’ve proposed. The good is that CMS really wants to innovate, and as you know many of the regulations make it hard to innovate, and so they’re really listening closely and very excited to experiment. We think that that change in reimbursement for the physicians may actually have a deleterious effect. That is, if we drive more physicians into big medical centers where those drugs are actually paid for by the medical centers at a higher rate, that that also the use of the 340B, that’s what’s going to happen is they’ll have fewer doctors practicing in private practice. It would be a little more inconvenient for patients, but it may be a lot more expensive for payers. 

 
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