Empowering Medicare to directly negotiate drug prices, accelerating the adoption of value-based care, using philanthropy as a catalyst for reform and expanding senior-specific models of care are among recommendations for reducing healthcare costs published in a new special report and supplement to the Winter 2019-20 edition of Generations, the journal of the American Society of Aging.
The report, "Older Adults and America's Healthcare Cost Crisis," includes a dozen articles by experts and leaders from healthcare, business, academia and philanthropy.
The authors examine the major drivers of the high cost of healthcare and its impact on patients, then offer solutions that can reduce costs and potentially improve the quality of care for older adults and society at large.
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Topics include the employer's role in reining in healthcare prices; the high cost of prescription drugs; investing in the social determinants of health; the value of home-based acute care; the need for oral health programs for older adults; value-based payment reform; and the geriatric emergency care movement.
WHAT'S THE IMPACT
In the report's lead article, West Health President and CEO Shelley Lyford and Timothy Lash, chief strategy officer of West Health and president of the West Health Policy Center, called for allowing Medicare to directly negotiate drug prices with manufacturers, which is currently prohibited by law.
They write it "would be a game-changing lever that could force prescription drug manufacturers to bring down prices and lower costs for older Americans." They also said it's essential to quickly move from unfettered fee-for-service to value-based payment models, and that more transparency on price and quality is needed so consumers and other purchasers can make more informed decisions about care.
Among the other recommendations are for employers to demand greater price accountability from hospitals and health plans, and to take the lead in adopting value-based payment models.
Authors also call for establishing senior-specific models of care, including geriatric emergency departments, which may improve health outcomes and reduce hospital admissions, and senior dental centers, which can address what they call an epidemic of oral health problems among older adults.
They also support widespread use of home-based acute care, which they say increases the value of healthcare.
THE LARGER TREND
As spiraling U.S. healthcare costs dominate policy agendas at the state and federal level, older adults -- the largest group of consumers of healthcare services -- have a particularly high stake in solving the crisis. According to a 2019 West Health-Gallup poll, seniors withdrew an estimated $22 billion from long-term savings in the past year to pay for healthcare and an estimated 7.5 million were unable to pay for a prescribed medicine.