From a Wall Street Journal Opinion article (Feb 10, 2020):
How to address the elder-care crisis? Ideally, doctors would screen older patients for dementia. An early diagnosis helps patients understand treatment options, plan for the future and receive appropriate care in the hospital.
Other steps include: more preventive care, changes to Medicare’s rehabilitation policies, adopting new reimbursement methods, and developing new measures of success. Primary-care offices can prevent hospital visits, but Americans seeking primary care face an average wait time of 24 days. This might not be a problem for a patient in need of an annual physical, but conditions like chest pain or infections require prompt treatment. Primary-care offices that offer same-day sick visits, home visits for bed-bound older adults, or at-home monitoring of conditions could reduce emergency department volumes.
According to a recent Kaiser Family Foundation poll, seven in 10 Americans say they would prefer to die at home. And that’s the direction the health care system is moving, too, hoping to avoid unnecessary and expensive treatment at the end of life.
Hospice allows a patient deemed to have fewer than six months to live to change the focus of their medical care — from the goal of curing disease to a new goal of using treatments and medicines to maintain comfort and quality of life. It is a form of palliative care, which also focuses on pain management, but can be provided while a patient continues to seek a cure or receive treatments to prolong life.
Seema Verma, administrator for the Centers for Medicare and Medicaid Services, sits down for a rare one-on-one interview with special correspondent Sarah Varney of Kaiser Health News. They discuss President Trump’s plan for sustaining public health insurance programs, how the administration would respond if Obamacare is struck down by the courts in the future, and the latest Medicare for all proposals.
Medicare negotiation of prescription-drug prices would bring U.S. government policies in line with those of other high-income countries, and the idea is popular with both the public and policy analysts. But it would represent a sea change for pharmaceutical firms, which will maintain that any threat to their pricing power will slow innovation.
Negotiating prices of 10 too-little drugs and 10 too-late drugs to levels currently paid in the United Kingdom would produce about $26.8 billion in savings in 2019 alone, most of which ($25.9 billion) would come from savings on drugs in the latter category. Over time, the drugs included could change. For instance, in 2020 this category might include Revlimid (lenalidomide), which generated $6.5 billion in 2018 U.S. sales; its price in the United Kingdom is 32% of that in the United States.
Americans all along the political spectrum favor allowing Medicare to negotiate the prices it pays for prescription drugs.1 In September, House Speaker Nancy Pelosi (D-CA) introduced what is now called the Elijah E. Cummings Lower Drug Costs Now Act of 2019 (H.R. 3), and the bill would have Medicare do just that.
Although there are draft pieces of legislation and regulation that take aim at the rising cost of drugs, H.R. 3 is the legislative tip of the spear for price negotiation. If it became law, Medicare would target drugs that claim the largest share of the health care budget and that face limited competition from generics or biosimilars. I propose an alternative set of drugs for price negotiation: those that have too little evidence to support full approval or are too late in their life cycle to justify continued high prices.
The purpose of the centers is to increase customers’ understanding of Medicare, match them with people who can talk with them about their benefits or new plans to enroll in, and access in-store annual wellness visits.
In addition, Walgreens and UnitedHealthcare are partnering for a new AARP Medicare Advantage Walgreens health plan. The health plan aims to deliver lower prescription drug costs to members, as many of the plans have $0 premiums and $0 copays on primary care visits, preventive care and some generic drugs. The 46 plans will be sold across 24 states.
Under a multiyear agreement, UnitedHealthcare will open 14 Medicare service centers in Walgreens stores across the U.S., the organizations said Nov. 25.
UnitedHealthcare, the health insurance arm of UnitedHealth Group, will operate Medicare service centers in Walgreens stores across five cities: Las Vegas, Phoenix, Cleveland, Denver and Memphis, Tenn. The centers are slated to open in January 2020.