Panel dives into what to do about healthcare costs
Supporting access to preventive care, addressing the social determinants of health and taking steps to curb high drug prices could help bend the healthcare cost curve, healthcare industry stakeholders said at a Wisconsin Health News panel Tuesday. Meanwhile, a patient advocate called for larger-scale public policies.
Wisconsin Association of Health Plans CEO John Nygren said preventive care and utilization management, like prior authorization, can support healthcare affordability.
“Those are the types of things that we can invest in and actually reduce those overall costs,” Nygren said.
Dr. Mark Cockley, senior vice president of population health for the north region of Froedtert ThedaCare, called for addressing the social determinants of health, like people’s economic and educational status, along with promoting healthier diets and exercise.
“Healthcare needs to be there to help support them, but there’s so much more that we need to be upstream to be able to curb that cost,” he said.
He said that providers should help patients access cheaper alternatives to brand-name drugs too.
Peter Fotos, deputy vice president of state advocacy at Pharmaceutical Research and Manufacturers of America, called for banning copay accumulator programs, which would allow drug coupons to count toward patients’ out-of-pocket limits.
He also suggested delinking the pricing and rebates that pharmacy middlemen provide from drugs’ list prices.
“We want to see more of the rebates going to the patients and not necessarily back to the plan sponsor,” he said.
Sean Stephenson, senior director of state affairs at the Pharmaceutical Care Management Association, said Wisconsin has “done a great job” by not passing legislation that would ban copay accumulator programs.
“It should be left up to the sponsor that is providing the benefits for their employees if they need that cost-saving tool or not,” he said.
Raj Shukla, state director at AARP Wisconsin, said there are simpler ways to address consumers’ costs, like expanding Medicaid and supporting caregivers. He called for a “focus on the people instead of, perhaps, an overabundance of focus on the industry.”
“I just want all of us, as we leave this discussion today, to go home and talk about who is actually impacted here,” he said. “It’s families that are spending thousands of dollars on a healthcare system that is not helping them right now, and it’s families that are cutting back food because they have to pay for medicine or vice versa.”
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