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National Healthcare Expenditure Data Issued for 2022: What Does It All Mean?

One of my Christmas traditions is to write about the release of the Centers for Medicare and Medicaid Services (CMS) Actuary’s National Healthcare Expenditure Data (NHED) for a given calendar year.  This usually is released in the first half of December each year for the prior year.  It literally takes CMS about a year to capture, calculate and categorize all the data for a year given the size and labyrinthine complexity of our healthcare system.  Each year as well, usually in the first half of June, the CMS Actuary updates healthcare spending projections for ten outyears. Why is this so important?  First, it is the main comprehensive source of data for calculating the history and future of healthcare spending.  Most other studies rely on the CMS Actuary’s NHED reports in some way.  Second, it is a treasure trove of data that helps explain the inner workings of the healthcare system.

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PBM Transparency And Reform Is A Big Trend In The American Healthcare System

The push for lower drug prices in general and reform of America’s Pharmacy Benefit Management (PBM) industry specifically are major focuses of Capitol Hill and state and federal regulators. With these trends taking center stage, I thought it would be interesting to lay out where the impetus for reform is coming from and what the future likely holds. I don’t pretend this is an exhaustive piece, but it is meant to set the table for future discussions and blogs. It is clear to me that the push for reform substantially is coming from outside the industry, but there are clear trends even within the drug and PBM industry toward change. What is the current status? It is critical to recognize that PBMs alone do not set prices in American healthcare. We have a tremendously opaque drug supply channel that begins with drug makers. The below walk-through is simplified and does

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New Poll Shows Americans Want To Work To Improve The Current Healthcare System Not Replace It

In my last blog on December 7, I argued that former President Donald Trump gave Democrats an issue to run on in 2024 when he stated on two occasions that he wanted to repeal the Affordable Care Act (ACA). I argued that the Republican party has a “compassion gap” and Trump signaling he would repeal the ACA widens that gap and gives a leg up to the Democrats. A recent Kaiser Family Foundation (KFF) poll showed that the ACA was a very important issue for about half of those surveyed and that about a third of Republican voters felt that way. In general, on healthcare issues, the poll underscored that voters may trust the Democrats more. As I noted, my blog was published on December 7 and later that day a new poll was published that underscores my views. The poll had 2,000 respondents and was conducted by the Partnership

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Republicans Have a Compassion Gap But Trump Gives Democrats Momentum on Healthcare Anyway

Former President Donald Trump recently brought up the possible repeal of the Affordable Care Act (ACA) and has put his (and my) party in a bind. Republicans suffered at the polls on the very issue Trump has resurrected. Why is he raising the status of the landmark act again? In a post on Truth Social on November 25, Trump declared: “The cost of Obamacare is out of control, plus, it’s not good Healthcare. I’m seriously looking at alternatives.” He clearly caught his party by surprise. You could hear the collective signs and groans coming from Capitol Hill Republicans who survived the issue in the past. After some criticism, Trump sought to clarify his remarks but actually reiterated his stand. On November 29 on Truth Social, Trump stated: “I don’t want to terminate Obamacare, I want to REPLACE IT with MUCH BETTER HEALTHCARE. Obamacare Sucks!!!” Fellow candidate and FL Gov. Ron

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