Friday, January 3, 2014

Back to the drawing board (ho hum)

Another bright idea bites the dust;
Some supporters of President Barack Obama's health-care overhaul say that putting uninsured Americans on Medicaid will reduce costly emergency-room visits by giving them more access to care in other settings.
But a new study found the reverse: A group of 10,000 low-income Oregon residents who recently obtained Medicaid coverage visited ERs 40% more often than those without insurance.
The new Medicaid recipients used ERs more often for all kinds of health issues, including problems that could have been treated in doctors' offices during business hours, according to the study published Thursday in the journal Science. Earlier studies had found the same patients used more of other medical services as well.
"Now we know—the hope that Medicaid will save money turns out not to be correct, at least in the first two years," said Amy Finkelstein, a Massachusetts Institute of Technology economist and a principal investigator of the study.
At least their prescription drugs will be less costly?
Retail generic drugs usually get cheaper over time. But our exclusive analysis ...shows that about one-third of generic drugs have gotten more expensive in the past twelve months.
Even more surprising, a small number have skyrocketed. Twelve drugs’ costs have increased by more than 2,000%. 
Their lips say, 'No, no, not Obamacare's fault.';
We can blame Obamacare for many things, but probably not generic price increases. Here’s what compliance expert Chris Cobourn of CIS told me:
 
“I can’t see how raising prices in advance of ACA gives any benefit. The big issue that will impact the industry, especially generics, is the change in the reimbursement landscape with the AMP based FULs and state reimbursement based on AAC. When the draft FULs were first published it was surprising to many, as well as worrisome, how low they were. Most on the manufacturing side were not surprised, as the FULs are calculated based on weighted average of the brand and the multiple lower price and higher volume generics. Raising prices could keep the FULs up, I suppose, but doing it now or post ACA Final Rule is really the same scenario.”
But, what about 'the change in the reimbursement landscape'. Where did that come from?

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