June 14 Web Event: Probing the Power and Practices of Pharmacy Benefit Managers June 14, 2023 Event Pharmacy benefit managers (PBMs) are increasingly scrutinized intermediaries in the U.S. health care system, negotiating discounts on prescription medications for health insurers and employers while collecting rebates from drugmakers. Even as PBMs have taken on a larger role in drug coverage and pricing in recent decades, including through mergers with…
The Health Wonk Shop: Probing the Legal Arguments in the Drug Industry’s Challenges to Medicare Drug Price Negotiations September 12, 2023 Event With the Biden administration’s announcement of the first 10 drugs to be negotiated for Medicare as part of the Inflation Reduction Act (IRA), an array of legal challenges from the pharmaceutical industry is potentially the biggest obstacle to implementation. In court filings, individual drugmakers and the industry’s main lobbying group…
The Health Wonk Shop: The Health Care Workforce Under Pressure – Strikes, Shortages, and Staffing Requirements November 16, 2023 Event Amid low unemployment and rising demand for services, today’s health care workforce is under pressure from several directions, including worker strikes; shortages of trained staff; and proposed new staffing standards for nurses and aides in nursing facilities. On November 16, a panel of three experts joined Larry Levitt, executive vice…
The Health Wonk Shop: Prior Authorization in Health Insurance: A Needed Tool to Contain Costs or an Excessive Barrier to Needed Care? February 22, 2024 Event Nearly 1 in 5 consumers with health insurance say their insurer delayed or denied care in the past year due to its requirements for prior authorization, a process through which insurers can require patients to obtain approval in advance before they will agree to cover specific services. Insurers…
The Health Wonk Shop: Primary Care Check Up: Why It Can Be Hard to Get an Appointment and How to Fix It April 3, 2024 Event Primary care has historically served as the backbone of our nation’s health care system, with patients often maintaining a relationship with a primary-care provider to guide their care over a period of years. Yet, the U.S. emphasizes primary care less than other high-income countries. And a shortage of primary-care…