Health policy expert lauds “bipartisan acknowledgement of the need for reform in Medicare”

Opinion
Video

“We have definitely seen significant trends toward transparency in hospital pricing, and in regulations designed to promote that, as well as PBM reform,” says Mara R. Holton, MD.

In this video, Mara R. Holton, MD, shared some health policy wins in urology in 2023. Holton is a urologist with AAUrology in Annapolis, Maryland and serves on the LUGPA board of directors.

Transcription:

What were some health policy wins in urology in 2023?

To focus on the wins, in a groundswell this year, we have seen bipartisan acknowledgement of the need for reform in Medicare. With 340B, there has actually been several years at multiple levels recognition that the 340B program is distorted in its support of big hospital systems as opposed to the underserved patients who it's really supposed to be benefiting. Additionally, this year, we saw a lot of legislation both on the House and Senate side, again, bipartisan bills about pharmacy benefit reform and access bills. It's really been very interesting to watch. I know that there's not a lot of nice play across the aisle, but as it pertains to health care, there really does seem to be burgeoning acknowledgment that we need to work together and that the system has some real flaws. That said, in speaking about 340B, the Supreme Court had reversed a decision about reimbursement related to 340B, and the hospitals will be receiving $9 billion in a lump sum payment this year to make them whole, so to speak. That's extremely concerning, because we know that when hospitals get big lump sums of money, they like to use that to acquire their entire marketplace and consolidate. I would say that that is going to be a challenge. Distorting marketplaces, continuing the price inflation that we see when consolidation trends continue. That really taxes the system. That said, in addition to those straightforward financial metrics, we have definitely seen significant trends toward transparency in hospital pricing, and in regulations designed to promote that, as well as PBM reform. So again, I think there's been a number of consumer and by consumer I mean, patient advocacy transparency initiatives that have gained steam, and I think that that's good for all of us.

This transcription was edited for clarity.

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