Study: No link between offering price transparency tool and lower healthcare spending

http://www.beckershospitalreview.com/finance/study-no-link-between-offering-price-transparency-tool-and-lower-healthcare-spending.html

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Offering a price transparency tool to a large insured population in California did not result in decreased healthcare spending, according to a study published in Health Affairs.

For the study, researchers analyzed the experience of beneficiaries of the self-insured California Public Employees’ Retirement System, a benefit manager for the state’s public employees, their dependents and retirees. CalPERS offered beneficiaries enrolled in an Anthem Blue Cross preferred provider organization a commercial price transparency tool called Castlight. Castlight was introduced to beneficiaries on July 1, 2014, and researchers conducted the study from July 1, 2012, to Sept. 30, 2015. Researchers said they specifically focused on “shoppable” services such as lab tests, office visits and advanced imaging services.

The study found no link between shoppable services spending and Castlight. Researchers said only 12.3 percent of beneficiaries offered the price transparency tool used it to conduct a price search at least once in the 15 months after it was introduced. Only 2.4 percent of beneficiaries used it at least three times during the 15 months, and 3.9 percent used it at least twice for searches with at least 30 days between searches.

The study found beneficiaries that did a price search prior to receiving imaging services on average paid 14 percent less than those who did not do a price search prior to those services. Researchers said only 1 percent of beneficiaries who received advanced imaging conducted a price search.

“We did not find evidence that offering a price transparency tool was associated with a reduction in spending on shoppable services. Patients’ use of the tool was associated with lower-price imaging services, but because use of the tool was so limited, this result did not translate into meaningful spending reductions among the population offered the tool,” the study’s authors concluded.

Specialty Drug Costs Soar 30% For California Pension Fund

Specialty Drug Costs Soar 30% For California Pension Fund

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Specialty drug costs jumped 30 percent last year to $587 million for the California Public Employees’ Retirement System, one of the nation’s largest health care purchasers.

Though they amount to less than 1 percent of all prescriptions, specialty drugs accounted for more than a quarter of the state agency’s $2.1 billion in total pharmacy costs. Those overall drug costs have climbed 40 percent since 2010.

The new figures show just how much financial pressure many employers and government agencies face from rising drug costs and why it’s become such a hot topic in California politics and on the presidential campaign trail.

Hepatitis C drugs drove much of the increase for the state retirement system during 2015, as did two rheumatoid arthritis drugs. Drugs for cancer and multiple sclerosis were also among the top 10 specialty drugs for CalPERS.

CalPERS spent the most, $94.5 million, on Harvoni, a hepatitis C drug. It is sold by Gilead Sciences Inc., whose steep prices have drawn public outrage and government scrutiny. The agency spent an additional $16.6 million on Sovaldi, another Gilead drug for hepatitis C.

Apart from specialty medications, CalPERS’ highest-cost drugs were Lantus, for diabetes; Advair, an asthma inhaler; and Crestor, a cholesterol medicine. Painkiller OxyContin rounded out the top 10 at $14.3 million, according to state data.

More than 5 percent of CalPERS’ total drug spending — $118 million — went for Humira and Enbrel, two anti-inflammatory biotech drugs that don’t face competition from lower-priced generics.

Worthwhile California initiative

Worthwhile California initiative

Worthwhile California initiative

At a time when health care spending seems only to go up, an initiative in California has slashed the prices of many common procedures.

The California Public Employees’ Retirement System (Calpers) started paying hospitals differently for 450,000 of its members beginning in 2011. It set a maximum contribution it would make toward what a hospital was paid for knee and hip replacement surgery,colonoscopies,cataract removal surgery and several other elective procedures. Under the new approach, called reference pricing, patients who wished to get a procedure at a higher-priced hospital paid the difference themselves.

Blaming drug costs, CalPERS considers 7% hike in HMO premiums

http://www.bizjournals.com/losangeles/news/2015/06/17/blaming-drug-costs-calpers-considers-7-hike-in-hmo.html?ana=e_du_pap&s=article_du&ed=2015-06-17&u=FAuoHGaGEPdmk4X6khnaiw045b16af&t=1434641073

The California Public Employees' Retirement System is poised to raise HMO premiums for state employees an average of 7.2 percent in 2016, evidence that rising hospital and drug costs could mean higher premiums in the private sector, too.