Affordability & Price Transparency
Expert articles and analysis related to affordability & price transparency.
AI Summary â Last 7 Days
CMSâ affordability agenda is moving through operational transparency levers, with new prior authorization transparency requirements for MA, Medicaid managed care, and ACA marketplace plans pushing payers toward more standardized electronic PA workflowsâimportant for VBC groups because denial patterns, turnaround times, and administrative burden increasingly affect total-cost and access performance (HFMA). At the same time, Medicare Advantage competition is fragmenting: large insurers are retrenching while SCAN expands its Costco partnership, signaling a retail-enabled, consumer-affordability play in a market under margin pressure (Fierce Healthcare). New USC Schaeffer research on hospital-affiliated insurers adds a policy risk layer for integrated delivery systems, suggesting regulators may scrutinize whether ownership structures enable favorable coding/payment dynamics rather than genuine value creation.
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After a lower court rejected Teva's case last fall, a federal appeals court has revived part of the drugmakerâs lawsuit against Medicare negotiations. The DC Circuit Court ruled on Tuesday that Teva...
Response to Senate Finance Committee request for information on policies for lowering drug prices
Response to Senate Finance Committee request for information on policies for lowering drug prices  Brookings
Comments on the Medicare Drug Price Negotiation Program proposed rule for IPAY 2029
Comments on the Medicare Drug Price Negotiation Program proposed rule for IPAY 2029Â Â Brookings
Legislative Proposals Aim to Modify the 340B Program
STAT+: The White House declares âpromises made, promises keptâ on lowering drug prices. Nice try
In its effort to lower drug prices, the White House has declared "promises made, promises kept." That's a narrative that doesn't reflect the full story.
Trump is taking credit for lower list prices. But a Biden-era law did a lot of the heavy lifting
List prices for brand-name drugs have declined significantly in 2026. But the reasons behind it may have more to do with a Biden-era law than any of the Trump administration's recent initiatives, expe...
Businesses increase support for hospital price caps
Business groups increasingly support various approaches to cap hospital prices. Although many business groups continue their traditional opposition to any government price controls, an increasing numb...
Hospital Price Transparency Legislation Will Burden Poor and Rural Patients
By DAVID INTROCASO Last month the House Energy and Commerce and the Senate Health, Education, Labor and Pensions (HELP) committees passed three hospital price transparency (price T) bills by a combine...
Employers to face 9.5% rise in healthcare costs in 2027: Aon
Employers to face 9.5% rise in healthcare costs in 2027: Aon  Modern Healthcare