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What We're Reading: Pharma-Payer Alliance on Drug Pricing

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What we're reading, November 26, 2015: CMS blog on step-wise transition to value-based care, payer-drug industry alliance on drug pricing, and a new model to override the proposed ACA tax credits.

CMS Head Explains Real-World Efforts in the Volume to Value Transition

In a blog highlighting the concrete steps taken by CMS to translate the vision of value-based healthcare into reality, Patrick Conway, MD, acting principal deputy administrator, chief medical officer, and director of the CMS Innovation Center, wrote about recent changes to payment rules that underscore the organization’s commitment to quality, value, and patient-centered care. These changes include creation of the home health value-based purchasing model, replacing the sustainable growth rate with the Merit-Based Incentive Payment System and incentives to participate in Alternative Payment Models.

Read the blog here.

PharmaPayer Alliance on Drug Price on the Horizon?

Drug makers and payers are considering a radical response to rising drug prices: working in tandem! After years of struggle with cost and risk-shifts, lobbyists representing each faction are considering cooperation as a tool to shape a federal legislation that would meet the interests of all involved. Political pressures are also forcing the 2 groups to develop a unified response to high drug prices.

Read the complete article here.

Premium-Support Model In Place of ACA Tax Credits?

A collaborative study, seeking to replace provisions within the Affordable Care Act, analyzes whether a “premium-support” model—where tax credits are fixed amounts for enrollees regardless of their premium costs—could replace financial burdens of the ACA on low-income and older adults. Evan Saltzman of the University of Pennsylvania’s Wharton School and Christine Eibner of RAND discuss the findings of their study that could help prevent the disparities, in The Commonwealth Fund Blog.

Read the blog here.

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