December 14, 2018

Drug Pricing - Patients Deserve to Know

On December 13, ACOFP delivered a letter to CMS on Drug Pricing Transparency. ACOFP states that the organization is in favor of disclosing pricing on all drugs that are advertised through direct-to-consumer means. This includes online, TV and print publications. With the FDA requiring disclosure of a drug’s approved indication, study data, safety, side-effects and adverse events, the price of the drug to the patient completes the picture.

From a physician’s view, this may change the conversation with patients who request the newest drug they saw on TV. For the patient, it may mean more research into the coverage of certain drugs and what portion they pay.

Think Tank Report on GME and Primary Care Shortage;
Medicare Advisory Commission Confirms Findings

On December 3, the Brookings Institution’s Center for Health Policy and the USC Schaeffer Center for Health Policy & Economics issued a report entitled, Medicare Graduate Education Funding is Not Addressing the Primary Care Shortage: We Need a Radically Different Approach. Overall, the researchers found:

  • The mix of physicians in the US has too few primary care physicians (PCPs) and too many specialists.
  • The income gap between PCPs and specialists is a major determinant of the PCP/specialty mix.
  • Medicare physician payment policy is a major contributor to the income gap.
  • While Medicare graduate medical education (GME) payment policies do not appear to be a potent force in specialty determination, they also do not provide a counterforce to the influence of the gap. 

With respect to GME funding, the researchers concluded that changes in GME payment to hospitals to favor training of PCPs have little potential to make a meaningful difference because other incentives affecting physicians-in-training and teaching hospitals are too powerful. The researchers state that redirecting these resources towards loan forgiveness for those medical students who pursue careers in primary care appears more promising.

Further, the researchers state that none of the approaches focused on medical education are likely to be fully successful unless the Medicare relative value scale is also revamped so that it contributes less to the income gap.

Following the release of this report, the Medicare Payment Advisory Commission (MedPAC) held its monthly meeting on December 6 and 7. During its session on payment adequacy for physician and other health professional services, MedPAC discussed the “wide disparities in physician compensation” between primary care and other specialties. MedPAC Chairman Jay Crosson indicated that they would further examine primary care shortages at a future session in March or April.

ACOFP will continue to monitor developments, reports and data related to the primary care shortage as well as opportunities to advocate for member priorities.

ACOFP's Legislative Strategy and Advocacy

In 2017, the ACOFP Board approved the 2018 Principles of Health Care System Reform, which outlines changes that would benefit our members and their patients.

ACOFP advocates for government change that is imperative for primary care physicians to meet expanding health care needs. Improved payment, use of primary care first instead of specialists, improved chronic care and behavioral health programs, reduced cost of medications, improved interoperability with EMR systems, and reduced of paperwork and quality reporting burdens represent a major subset of what is required.

ACOFP consulted with Alston & Bird to assist with communicating our strategic policy goals to the administration, Congress, government agencies and local representatives. In 2017 and 2018, ACOFP submitted 13 comment letters on key issues to government agencies such as the Centers for Medicare and Medicaid (CMS), Department of Health and Human Services (HHS) and Congress.

If you are interested in serving on the Federal Legislation Committee, email [email protected].

The View from the Hill - an ACOFP member benefit - is prepared by ACOFP's Washington, DC-based lobbying firm, Alston & Bird. Send questions or comments to [email protected].