Hello Forum Friends,
While prescription drug costs are not the largest slice of the healthcare cost pie, they are the fastest growing slice. We have to figure out new strategies. Looking forward to hearing your thoughts at our upcoming Forum Member All-Stakeholder meeting on August 31st. Here is some background reading.
Gloria Sachdev
President and CEO, Employers’ Forum of Indiana
Inside the Forum
EFI Award Nominations
We are currently taking nominations for our Innovation in Healthcare, and Leadership in Healthcare Awards. You are welcome to self nominate or nominate someone. Please send nominations to Sara Otte at sara@employersforumindiana.org.
Presentations
In August, Gloria Sachdev was invited to give presentations regarding policy ideas to advance transparency, affordability, and competition to the following organizations:
- August 1: Employer Coalition of Louisiana
- August 15: National Academy for State Health Policy National Conference
Thank you for the opportunity to present!
Policy: Federal and State Legislation
Ongoing Challenges with Hospital Price Transparency
On August 9th, Gloria Sachdev published an Op-Ed in the Journal Gazette discussing current federal policies supporting healthcare transparency and competition. Read the full article here.
U.S. Announces First Drug Picked for Medicare Price Negotiations
The price negotiation program, as part of the Inflation Reduction Act, is expected to save the government tens of billions of dollars in the coming years.
Read the full New York Times article here.
Tax and Health Care Reform
Podcast: “As Indiana lawmakers look at the possibility of eliminating the income tax and looking at ways to lower Health Care costs for Hoosiers, we figured now would be a good time as any to speak with Ball State Economist Mike Hicks about the likelihood of either.” Listen here.
States’ Uphill Battle to Stop Runaway Health Care Costs
Tradeoffs Podcast: “One year of health insurance premiums for a family of four now costs as much as a car. Nine states are trying to lower those costs in an aggressive way – by holding hospitals and insurance companies accountable for high spending. In this episode we look to see if any of those efforts have bent the cost curve.” Listen here.
Indiana Supreme Court Won’t Rehear Abortion Law Ruling, Putting it Back in Effect
The Indiana Supreme Court denied a request to rehear its ruling upholding the state’s near-total abortion ban. That means the new law—which prohibits the procedure with only narrow exceptions—will immediately take effect once the ruling is certified on the court docket, which is expected to be a matter of days, according to court officials. Read the full IBJ article here.
Policy Experts Discuss Legislative Solutions to Rising Hospital Costs
“High quality health care at hospitals is important, but that doesn’t matter if people can’t afford it”, panel members said on August 16th during a morning session at the National Conference of State Legislatures. Read the full State Affairs article here.
Regulating Outpatient Facility Fees: States are Leading the Way to Protecting Consumers
Per the 2023 Indiana legislative session, Indiana’s 5 largest health systems will no longer be able to charge facility fees for off-campus services beginning January 2025. Gloria Sachdev participated in a Georgetown University roundtable discussing prohibiting facility fees with other states. Read the full Georgetown briefing here.
Update from the National Alliance of Healthcare Purchaser Coalitions
Reaching Fiduciary and Employee Satisfaction Goals
Self-funded employers have fiduciary responsibility to use health plan assets prudently and are required to complete a gag clause attestation form by December 2023 per the CAA. Watch Chris Deacon’s presentation from a past EFI meeting here and review her slide deck here.
On August 17th, the National Alliance of Healthcare Purchaser Coalitions held a 30 minute Fiduciary check in. Watch and review past meting materials here.
2023 Annual Forum: Temperature Rising
The National Alliance of Healthcare Purchaser Coalitions 2023 Annual Forum, November 13-15, will focus on imagining, designing and influencing the future of workplace health. Register at this link.
Mental Health in the Workplace
2024 Large Employer Health Care Strategy Survey
The 2024 Large Employer Health Care Strategy Survey asked employers a series of questions to gauge their perspectives on critical health care topics, such as the role that health and well-being play in overall workforce strategy and critical actions needed to advance health care quality. As in years past, the survey gathered key plan design and health care cost data to create aggregate findings on how employer-sponsored health care will change in the coming year. Fielded between June 1 – July 18, 2023, the survey was completed by 152 large employers that cover more than 19 million lives in the United States. Read the full report here.
Member Spotlight
Jenni Nolan, BPCA
Owner, Clear Healthcare Advocacy
Tell us how you got to the position you are in today.
I spent the first 20 years of my career in physician office management, where I learned how complex (and overpriced!) our healthcare billing system is. In my work, I spent a lot of my time chasing down payments from insurance and correcting billing and claims errors, etc. on behalf of our physicians. I also began to notice that about a third of the medical bills we received at home were incorrect, and I knew my household wasn’t unique. I decided I needed to do something to help other patients with their own billing messes, so I became a board certified patient advocate (BCPA) in 2019 and started Clear Healthcare Advocacy.
How do you feel that you are bettering your community and/or employees by the work that you are doing?
Patients are overwhelmed when they reach out to me for help. They’ve usually tried to resolve their insurance/billing issues on their own with no success. Often, they’re dealing with a cancer diagnosis or chronic illness and don’t have the time or energy to deal with billing issues. They may have a hospital bill they’re unable to afford and need help negotiating a balance, or they may have had a claim denied and need help with an appeal. I’m able to come alongside them and ease some of that burden so they can focus on their health or use their time for more important things.
What is something you look forward to doing this fall?
Travel!! I’m going to New Orleans in September for the Healthcare Advocate Summit, where I’ll get to hang out with and learn from other patient advocates. I’m also headed to Ireland with my husband to celebrate our 25th anniversary in October and will likely take a few road trips to Bloomington to tailgate with our daughter at IU.
In the News
Employers:
- Ford Motor Co Sues Blue Cross Blue Shield in Antitrust Case Over ‘Astronomical’ Profit (Reuters)
- Podcast: Should You Not Give Employee the Benefit Design They Think They Want? (Relentless Health Value)
Hospitals
- IU Health’s New Pharmacy Hub Aims to Cut Costs (IBJ)
- CEO of CHS Hospital in Indiana to Leave Role (Beckers)
- Nurses at Ascension Hospital Move to Unionize (Beckers)
- Hospital Prices For Commercial Plans Are Twice Those For Medicare Advantage Plans When Negotiated By The Same Insurer (Health Affairs)
- Indiana Hospital Notifies Hundreds of Patients They May Have Been Exposed to Tuberculosis Bacteria (APNews)
- Hospitals Facing Stricter Charity Care Oversight (Modern Healthcare)
- Your Exorbitant Medical Bill, Brought to You by the Latest Hospital Merger (KFF)
Insurers
- UnitedHealthcare’s Prior Authorization Cuts to Begin Sept. 1 (Beckers)
- KFF Survey of Consumer Experiences with Health Insurance (KFF)
- Cigna Ends Prior Authorization Requirements for 25% of Procedures (Beckers)
Providers & Physicians
- Marathon Health Buys Missouri Firm in Move that Boosts Membership by 32% (IBJ)
- Monetizing Medicine: Private Equity and Competition in Physician Practice Markets (AAI)
- Who Employs Your Doctor? Increasingly, A Private Equity Firm (NYT)
- Evaluating Trends in Private Equity Ownership and Impacts on Health Outcomes, Costs, and Quality: Systematic Review (BMJ)
- Physician and Nurse Well-Being and Preferred Interventions to Address Burnout in Hospital Practice Factors Associated With Turnover, Outcomes, and Patient Safety (JAMA)
- Relieving Nurse Burnout With AI Technology: Key Areas to Target (Beckers)
Pharmacy
- 340B—Where Do We Go From Here? (JAMA)
- Drugmakers Are ‘Throwing the Kitchen Sink’ to Halt Medicare Price Negotiations (NYT)
- FDA Approves Second Over-the-Counter Naloxone Nasal Spray Product (FDA)
- FDA Advisory Committees for New Prescription Drugs (AMA Ed Hub)
- A Peek at Big Pharma’s Playbook That Leaves Many Americans Unable to Afford Their Drugs (KFF)
- CVS Health Launches Cordavis (PR Newswire)
Other Healthcare News
- Indiana Workplace Substance Use & Recovery Survey 2022 (Indiana Chamber)
- A Look at the Latest Suicide Data and Change Over the Last Decade (KFF)
- The Distribution of Additional Residency Slots to Rural and Underserved Areas (JAMA)
- HHS invests $100 Million to Bolster Nursing Workforce (Modern Healthcare)
- Medicaid Enrollment and Unwinding Tracker (KFF)
- Study: Indiana Ranks Among Fattest States, Which Comes With $9.3B Economic Hit (IndyStar)
- ‘Asian Glow’ From Alcohol Isn’t Just a Discomfort. It’s a Severe Warning (Washington Post)
- 85 Counties Opt in for Enhanced Public Health Funding Before Deadline (IBJ)
Do you have a suggestion or contribution for our next newsletter? Contact us.