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National Obesity Care Week: Behind the Scenes of Obesity

September 19, 2019
4:19 pm

September 16-20 is National Obesity Care Week (NOCW).  NOCW is a source for science-based information on obesity.  More than 93 million Americans are affected by obesity, with an estimated cost of $480 billion to the healthcare system.  The Healthcare Leadership Council (HLC) has joined as a partner of NOCW, advancing our conviction that people who struggle with obesity deserve access to quality care and must be treated with dignity and respect.

Recently, HLC has been focused on how the healthcare system can utilize research on social determinants of health so that essential socioeconomic and environmental factors can be considered and addressed in addition to one’s clinical care.  At the beginning of this week, HLC hosted a Hill briefing that had an expert panel present on reducing disparities in health.  While this particular briefing looked at the whole patient from a pediatric and senior perspective rather than zeroing in on obesity, there is a strong relationship between obesity and low socioeconomic status that cannot be ignored.

Many HLC members have recognized the need to reach out and invest in the well-being of surrounding communities:

  • BlueCross BlueShield of Tennessee has taken many avenues to encourage healthy lifestyles of Tennesseans, such as revitalizing neighborhoods with parks, and repaving the roads with bike lanes.
  • The Bristol-Myers Squibb Foundation provided resources to establish one of New Jersey’s largest and most comprehensive children’s hospitals which includes a clinical center of excellence dedicated to the study and treat childhood obesity.
  • Fairview Health System launched a new 24-week Healthy Lifestyle Plan that combines evidence-based weight loss strategies with one-on-one lifestyle coaching.  This approach can address medical issues that make it hard for someone to lose weight on their own, such as hormone levels, the side effects of prescription drugs, or chronic conditions like sleep apnea.
  • Teladoc Health has invested in a personalized virtual care platform for physical and behavioral health, addressing the root of the problem for chronic disease with digital therapeutic interventions and sustainable behavioral change.

It is promising that across the healthcare spectrum there have been a variety of solutions offered to address obesity, but much progress must still be achieved to make a lasting impact on the health of millions of Americans.  Many people do not know that obesity is a disease, and education is the just the first step to achieving NOCW’s goal of access to comprehensive obesity care.  More voices are needed to enact change.  Additional information about ways to take action is available on ObesityCareWeek.org/ACTION.

Importing Prescription Drugs Will Create More Problems than it Solves

September 11, 2019
12:03 pm

Several years ago, there was a significant push in Congress to allow wholesale importation of prescription drugs from other countries into the United States.  The Healthcare Leadership Council found itself in an opportune position to examine this idea, given that our membership includes not only pharmaceutical manufacturers and healthcare payers, but also the companies that would facilitate the distribution of these imported products.

We found that the promised cost savings from importation were an illusion.  When shipping, relabeling, storage, liability coverage and other costs were factored into the mix, the cost differential between medicines in this country and those from countries that employ government price controls was largely erased.  It has never been surprising that HHS Secretaries and FDA Commissioners from both Republican and Democratic presidential administrations over the years have attested that the risks connected with drug importation far exceeded any possible rewards.

But now the issue is back in a big way.  States – including Vermont, Colorado, and Florida – have passed legislation to set up their own drug importation programs, pending federal government approval, and the current administration has indicated a willingness to work with them in making this happen.  Also, Congress is once again considering importation legislation. This is troubling.

The only difference between the drug importation issue today and when we first examined it is that the dangers have exacerbated while the benefits have not.  There are certain facts that policymakers should keep in mind when contemplating the prospects of opening our borders to drugs from outside the U.S.

  • We already have a drug crisis in this country, much of it fueled by the proliferation of lethal fentanyl that is originating in other countries and finding its way here through our ports and via the international mail service.
  • The world is facing an enormous health challenge driven by the increase in counterfeit drugs. The World Health Organization has estimated that one in every 10 pharmaceutical products in low- and middle-income countries is falsified or substandard.  Opening our borders increases our exposure to this danger.
  • Since we first examined this issue, there has been an explosion in the number of online pharmacies.  According to the National Association of Boards of Pharmacy, there are over 35,000 online drug sellers and 96 percent of them are in violation of applicable laws.  Many of these operations are based in Canada, the nation often cited as the safe place from which to import drugs.
  • And just to dispense with the notion that importing drugs from Canada will drastically lower prices, the numbers simply don’t work.  Canada’s population is barely more than one-tenth that of the United States and our neighbors to the north have already been enduring problems with drug shortages.  The idea that Canada can provide a sufficient supply of prescription medications to meet American demands is ludicrous.

By all means, we should be having a national conversation on healthcare affordability and accessibility in the United States, seeking solutions that will ensure patients have access to the treatments they need while also maintaining an environment that incentivizes lifesaving medical innovation.  A serious discussion requires credible ideas, though, and drug importation doesn’t fit that bill.

Congress Poised to Step Up for Medical Innovation

April 12, 2019
1:30 pm

In a city as divided along partisan lines as Washington, D.C. is these days, you don’t often come across a legislative idea that wins broad support from both sides of the aisle.  The fact that a majority of the U.S. House of Representatives is sponsoring legislation to repeal the medical device excise tax is a strong indicator that it’s time to act to take this counterproductive tax off the books.

This week, a House bill to repeal the medical device tax was introduced by a quartet of lawmakers, Representatives Ron Kind (D-WI), Jackie Walorski (R-IN), Scott Peters (D-CA) and Richard Hudson (R-NC).  This legislation has 227 original cosponsors and follows the introduction of a companion bill in the U.S. Senate by Senators Pat Toomey (R-PA) and Amy Klobuchar (D-MN).

Congress has previously acknowledged the inherent flaws in this tax by suspending its implementation.  The next logical step is full repeal.  A 2.3 percent excise tax on medical device company revenues – not profits – is extraordinarily punitive and disproportionately harmful to innovators still trying to establish themselves in the marketplace.  The tax has had a negative effect on investment and job creation and undermines medical innovation at a time in which we need to be incentivizing it.

Chronic disease continues to be the greatest driver of healthcare cost escalation.  By continuing to develop more effective treatments and technology, we can enable patients and their healthcare providers to better manage these conditions and reduce the frequency of emergency room visits and acute care episodes.  An excise tax on the tools needed to improve quality of life and achieve greater health system sustainability makes no sense.  A bipartisan majority of Congress wants to do away with this tax.  They should move expeditiously to do so.

Heroism Shouldn’t Be Discouraged By Legal Concerns

August 08, 2018
1:13 pm

There is legislation – the Pandemic and All-Hazards Preparedness Reauthorization Act – moving through the U.S. Senate right now that is essential in reauthorizing critical programs improving our public health infrastructure and response capabilities whenever an emergency occurs, last year’s hurricanes in Puerto Rico and the Gulf Coast still being all too fresh in our memories.  There is a provision in this measure that deserves highlighting.

The House of Representatives Energy and Commerce Committee included language from the Good Samaritan Health Professionals Act.  The Good Samaritan legislation essentially protects medical volunteers who offer their services during a large-scale disaster from lawsuits.  When a tornado, hurricane, or even a major pandemic strikes, we want physicians, nurses and other medical professionals to rush to the scene and provide their healing expertise to victims.  Due to inconsistencies in federal and state medical liability laws, though, these volunteers risk being turned away or having their assistance limited because of lawsuit concerns.

This legislation ensures that our priorities are in the right place – making sure that people in urgent circumstances receive the help they desperately need.  This legislation had bipartisan support in the House and we look forward to it receiving the same level of backing in the U.S. Senate.  The legislation must pass both houses before September 30.

Quantifying the Medicare Advantage advantage

July 25, 2018
2:51 pm

In the 15 years since its inception, the increase in popularity of Medicare Advantage (MA) – health coverage provided by private plans in contrast to traditional fee-for-service (FFS) Medicare – has been undeniable.  Roughly half of all Medicare-eligible seniors are enrolled in Medicare Advantage plan and that proportion keeps rising.

Now there is a new addition to the growing body of evidence that MA plans are not only serving their enrollees well, but is bringing greater overall value to the Medicare program than that generated by the FFS approach.

A newly-released study by Avalere Health, Medicare Advantage Achieves Better Health Outcomes and Lower Costs for Beneficiaries with Chronic Conditions Compared to Fee-for-Service Medicare, finds that Medicare Advantage is outperforming traditional FFS Medicare with higher rates of preventive screenings, fewer avoidable hospitalizations, and fewer emergency room visits.  In other words, healthier patients and significant dollar savings.

Overall, the Avalere study found that MA beneficiaries had 23 percent fewer emergency stays and 33 percent fewer emergency room visits than their peers in FFS coverage.  This wasn’t the result of MA plans enrolling healthier individuals at the outset.  Rather, the study found that a greater percentage of MA beneficiaries were in clinical and social risk categories that traditionally drive up costs in FFS Medicare.

Avalere found that MA outperformed FFS on a range of cost, utilization, and outcome metrics in caring for individuals with one or more chronic health conditions.  Among patients with diabetes, for example, those enrolled in MA experienced 73 percent fewer serious clinical complications than FFS beneficiaries.  And patients dually eligible for Medicare and Medicaid – who generally have more complicated and serious health conditions – had 49 percent fewer hospital visits and a 17 percent lower average-cost-per-beneficiary in MA plans.

Former Congresswoman Allyson Schwartz, president and CEO of the Better Medicare Alliance (of which the Healthcare Leadership Council is a member) said “this study adds to the growing body of evidence showing the ability of Medicare Advantage to align incentives to better manage the care for a high-need population with multiple chronic conditions.”  These patients, of course, account for the most significant portion of our country’s healthcare spending.

This study adds fuel to the argument that we can enhance healthcare quality and better contain spending through improved patient health when healthcare entities compete on the basis of value.