Section 340B of the Public Health Service Act is a drug pricing program enacted by Congress in the early 1990s. Prior to 340B, Congress created the Medicaid Rebate program in the Omnibus Reconciliation Act of 1990 due to the high costs that Medicaid was paying for outpatient drugs. The program calls for drug makers to create a rebate agreement with the Department of Health and Human Services (HHS) in a manner that is similar to the discounts manufacturers provide for large purchasers. If an arrangement is not reached with the HSS, the drug is ineligible for federal Medicaid coverage. [1] Two years after the implementation of this program Congress found that a flaw in calculating their “best price” for certain rebates. They did not take into account the pre-existing discounts that drug companies were giving to clinics and hospitals that provided services for uninsured patients. Failing to incorporate these discounts, the “best price” set by the government for certain drugs were in reality significantly higher than what these locations were previously paying. As a result, 340B was created and designed to protect these clinics and hospitals from these price increases as well as providing aid in the form of …show more content…
[2] And this is what I believe is most important about 340B. I got to witness firsthand how this program changes people lives. At my previous co-op, I worked at CVS Careplus which serves as the Health Safety Net pharmacy affiliated with Beth Israel. The majority of the patients are elderly and/or fall well below the poverty line but were unable to qualify for MassHealth standard. Many have chronic conditions such as hypertension or diabetes and would personally tell me that without the Health Safety Net program, tell me they would not be able to receive any medical care. So I am very interested to see how Beth Israel will work directly with a program like
DSRIP funding is used to offer financial incentives to health care providers that develop and implement projects aimed at improving how care is delivered to low-income populations. Specifically, the providers (often referred to as the “performing providers” or “performers”) propose and execute projects like programs, strategies, and investments designed to enhance access to health care, quality of health care, cost-effectiveness of services, and health of the patients and families served. Based on the completion of their project milestones, they receive DSRIP payments. Milestones are objectives of the projects, comprised of metrics indicating their progress, and the providers must achieve the milestones in order to claim the associated incentive funds. DSRIP projects are spanned over five demonstration years, DY1 through DY5. And each demonstration year has separate project milestones, metrics, and incentive funds. If providers fail to fulfill certain milestones, the fund...
The United States (U.S.) has a health care system that is much different than any other health care system in the world (Nies & McEwen, 2015). It is frequently recognized as one with most recent technological inventions, but at the same time is often criticized for being overly expensive (Nies & McEwen, 2015). In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) (U. S. Department of Health & Human Services, n.d.) This plan was implemented in an attempt to make preventative care more affordable and accessible for all uninsured Americans (U.S. Department of Health & Human Services, n.d.). Under the law, the new Patient’s Bill of Rights gives consumers the power to be in charge of their health care choices. (U.S. Department of Health & Human Services, n.d.).
The topic of reproductive rights surrounding women in Texas has been a hot buttoned issue since the closing of many reproductive centers across the state. Recently damaging abortion restrictions were passed and therefore encroached on women’s reproductive rights even more by decreasing access to abortion care. Texas’ 84th Legislature both passed HB 3994 as a law and had it made effective by state governor Greg Abbott on July 8 of this year. This law complicates access to abortion services for mistreated and neglected minors and for those who do not possess specific identification cards in Texas.
The current state of affairs in the development of health policy in the United States is that it is constantly in flux and its implementation is disorganized and inefficient. As was the case with the recently passed Affordable Care Act legislation, political and lobbying interests often intersect in a manner that makes meaningful, most appropriate changes unlikely. The ACA kept in place the fractured nature of American health care and insurance, and appears to have benefited insurance companies by increasing enrollments rather than making the care provided better on a large scale. The majority of the plans on the created exchanges, up to 87%, are funded by federal subsidies (Blumenthal, Abrams, & Nuzum, 2015). These plans must cover individuals regardless of pre-existing conditions. The burden of the cost of insurance shifted to tax-payers and the young/healthy who are now overly burdened with mandatory coverage that they may or may not need in
A very notable goal is to make healthcare affordable for all Americans and at the same, improving the quality and efficiency in which healthcare is conducted. Many look at this act and notice the key benefits that are provided for all Americans, and are interested to find other improvements that help everyday ...
On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173). This landmark legislation provides seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. One month later, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the figure presented by the Bush administration during Congressional debate. The inaccurate figure helped secure support from fiscally conservative Republicans. It was reported that an administration official, Thomas A. Scully, had concealed the higher estimate and threatened to fire Medicare Chief Actuary Richard Foster if he revealed it. By early 2005, the White House Budget had increased the 10-year estimate to $1.2 trillion.
Within the previous four years, the number of uninsured Americans has jumped to forty five million people. Beginning in the 1980’s, the American Academy of Family Physicians (AAFP) has been trying to fix this problem of health insurance coverage for everyone with a basic reform. The AAFP’s plan imagined every American with insured coverage for necessary improved services that fall between the crucial health benefits and the surprising costs. (Sweeney) They expect by fostering prevention, and early prevention, with early diagnosis with treatment, the program would result in decreased health system costs and increased productivity through healthier lives. The way to achieve health care coverage for all is pretty simple. This country needs the United States congress to act out legislation assuring essential health care coverage for all.
The United States spends more per capita on health care than any other country, with the percentage of gross domestic product dedicated to health care doubling from 9% in 1980 to 18% in 2011(Kesselheim,). One of the contributors to health care inflation is prescription drugs. Pharmaceuticals account for about 10% of total health care costs, spending on pharmaceuticals is poised to swell in upcoming years as a result of the increasing prices of complex specialty medicines (Kesselheim). Name brand drugs are going to have to be set at higher prices, in order for pharmaceutical companies to receive a profit. If the patient has full coverage on a medication, there is a greater chance that medication will be taken, although it may not be
Clearly, the Medicaid program is ripe for a major overhaul, a task that the federal government has thus far been unwilling to undertake. I chose this topic because I believe that the Medicaid program can be rescued and revitalized by leadership; otherwise, it is likely to be eroded. Medicaid is a government-sponsored program whose objective is to provide patients with health assistance upon meeting specific criteria. Medicaid is an insurance program that is available for disadvantaged persons, including the elderly, who cannot afford health benefits because of low incomes or other factors. This program is subsidized by government funds and in many instances, will cover the costs of basic medical care as well as specialized testing and supplies. What are the problems with Medicaid and what should be done about them? This paper will look at 6 articles about the economics of Medicaid and analyze what should be done about this problem.
Phillips, K. (2009, September 1). Catastrophic Drug Coverage in Canada (PRB 09-06E). Parliament of Canada . Retrieved March 12, 2012, from http://www.parl.gc.ca/Content/LOP/ResearchPublications/prb0906-e.htm
This paper will take into account the Affordable Care Act (ACA) Law and how all three branches of government are involved with the creation and analyze issues associated with the ACA. Subsequently the paper will describe the role of public opinion and lobbying groups. Thirdly this paper will evaluate the concepts of equity, efficiency, and effectiveness showcasing their role in the law and its passage. This paper will take into consideration the anticipated effects on cost, quality, and access, including discussing the balance of markets and the government. In closing this paper will highlight the anticipated effects on Medicare and aging as well as Medicaid and the poor. The ACA was signed on March 23, 2010 with the intention to offer all U.S. Citizens and residents a qualifying health care coverage plan. The law’s focus is to expand coverage, control health care cost, and improve health care delivery system.
While the purpose of The Patient Protections and Affordable Care Act is to improve the costs and quality of healthcare for all U.S. citizens and legal immigrants, the PPACA will accomplish this foremost by extending insurance coverage to millions of Americans who are currently without health insurance, as stated in Title I: Quality, Affordable Health Care for All Americans (The Health Foundation of Greater Cincinnati). By having everyone participate in the same health insurance pool, we can ensure a health insurance market that is more affordable for everyone. One of the problems with our health insurance market has been that people have a hard time getting insurance coverage on their own and its very costly and often does not cover a lot. The health refo...
Approximately 1 in 5 Americans do not have medical insurance and are more likely to lack a usual source of medical care, and more likely to skip routine medical care because of the very high costs, increasing their risk for serious health conditions. For the program, increasing the access to routine medical care and medical insurance are very important steps to achieve their goal of improving America’s health. The access to health services leading health indicators are those with medical insurance and a usual primary care provider. The access to health services in a regular basis can prevent disease and disability, detect and treat health conditions, increase quality of life, decrease the probability of premature death, and increase life
...ank Research (2010). Coverage vs. Cost. The US health care reform in perspective. Retrieved from http://www.dbresearch.com
The quantity medical care and issue depending on citizen preference, test, and income, the cost of the treatment and care depend on the cost of expenses minimize the point of service and market price set. The expense depending on the elasticity of medical care and demand as well on this situation the arrows welfare proposition (Pauly p. 532). Information problems can lead to a range of chance inefficiencies and purposeful troubles for the establishment of health care and health insurance by markets there is particular concern about the moral-hazard problem and opposing collection as subsets of unbalanced. Some of these problems, most noticeable and markedly, the Affordable Care Act dedicated practically fully of historically increasing government involvement through the insurances. The market failures afford to cover the arrow identified that the government support and undertake the insurance under any circumstances. The economic emphasizes that an equilibrium stretched through the goods forces and merchandise prices the market problem because of other equilibrium will make contributors be better off. Welfare measure, without making another person worse off is a value judgment. The health care problem and condition is extremely objective in value, and norms by decision maker under health and economics