As the New Year approaches, Team Health looks back at some highlights from the past year.

Examining the Effects of Recent and Proposed Reforms to Medicare Part D
The success of Medicare Part D depends on stakeholders’ incentives to control costs, but recently implemented and proposed changes could undermine those incentives, writes Deputy Director of Health Care Policy Tara O’Neill Hayes.

Redesigning Medicare Part D to Realign Incentives
The cost of Medicare Part D to the government is rising, writes Tara Hayes. She explores how to realign incentives to control costs for the government without hurting beneficiaries.

Medicare Part D: Why Altering the Non-interference Policy is Likely to Lead to Higher Costs
Continuing the theme of papers focused on Medicare Part D, health care expert Robert Book explains the dangers inherent in the government interfering in drug pricing.

Sizing Up the Proposed HRA Rule
The Trump Administration proposed loosening restrictions around Health Reimbursement Arrangements (HRAs), a move that could boost insurance enrollment and help stabalize the markets, writes former Health Policy Analyst Jonathan Keisling.

Is an International Price Index the Solution to High Drug Prices?
The Trump Administration’s has proposed linking Medicare Part B drug prices to an international price index in an effort to curb drug costs, but this approach could create several problems, contends Tara Hayes.

 

Chart Review

Team Health’s most-read paper from 2018 is a deep dive into the cumulative effects of overlapping policies on incentives in the Medicare Part D program. Tara Hayes examines how various proposed and enacted budgetary measures change the financial liability of insurers and beneficiaries. As the chart below shows, implementing the president’s budget on top of current law would drop insurers’ liability, while implementing it and rolling back provisions in the Bipartisan Budget Act of 2018 would increase their liability.

 

Worth a Look

Hot takes from the Weekly Checkup in 2018.

Rather than having a debate over the merits of these proposals [about the 340B program], opponents have resorted to the tried-and-true strategy of accusing those with whom they disagree of killing people. To these ads and their proponents, I can offer only a simple retort: “Grow up.” -“Let 340B” Jumps the Shark

In this edition of “I’m not a lawyer, but…” let’s take another look at the latest legal challenge to the Affordable Care Act. –The Politics of Preexisting Coverage Protections

In short, what the senators are proposing is the massive expansion of the ACA and the creation of a public option, something that was a bridge too far for President Obama and congressional Democrats in 2010. But don’t worry! Apparently it will all be paid for with dollar bills plucked from the magical federal money trees that grow in the basement of the Treasury Department. –Medicare Part E and the Magical Federal Money Tree

Supporters and opponents of the Affordable Care Act (ACA) have been locked in a death struggle over the law’s future for nigh unto eternity. As it turns out, there is something that can bring these two warring sides together: their mutual objection to funding the ACA’s cost sharing reduction (CSR) payments to insurers. –CSRs: Bringing People Together