President Donald J. Trump
The White House
Dear Mr. President:
On behalf of the Council for Affordable Health Coverage (CAHC), I write in anticipation of your upcoming announcement related to improving prescription drug access and affordability.
CAHC is a broad-based alliance with a singular focus: bringing down the cost of health care for all Americans. We share your support for lowering costs and improving access to affordable drugs through policy solutions that encourage and reward competitive markets. CAHC members are deeply grateful for the important strides already made towards this goal on your watch.
In most businesses, people are rewarded if they do a good job. Not so in federal and state health programs with respect to prescription drugs.
Today, our nation’s healthcare system is undergoing a monumental shift as payers move aggressively to reward value and deliver affordable, quality care to consumers. In such value-based systems, payment for a medicine is linked to patient outcomes, rewarding affordability and quality. Sadly, old laws and rules on the books prevent these private sector innovations from flourishing in Medicare and Medicaid. This shortchanges taxpayers and, most importantly, patients.
Your administration can change this flawed status quo by including commonsense reforms to federal rules preventing the use of value-based payment arrangements in federal programs as part of any administration-led drug affordability initiative.
Specifically, CAHC urges you to:
- Allow team-based care and payment: Federal law prevents insurers, biopharmaceutical manufacturers, doctors and patients from coordinating care. The Administration should create a safe harbor from the Anti-kickback statute (AKS) to allow these team-based models in Medicare and Medicaid.
- Use the latest technology to make value-based arrangements more fruitful: Such a safe harbor should also allow manufacturers and payers to share or donate technology (both hardware and software) that is necessary to monitor, track patient progress and automatically report outcomes to facilitate payment.
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