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With the new year came a federal mandate for hospitals across the country to release their chargemasters, or price lists, for all services offered at their facilities. What impact will this have on increasing price transparency for the average health care consumer? Will it help or hurt continued price transparency efforts?

The FDA approval and release of treatments for hepatitis C in late 2013 were a game changer in the treatment of this disease. But the price tags caught self-insured employers off guard. The launch of Sovaldi and other therapies paved the way towards a shorter and simplified means to a cure for these patients. This new class of specialty medications was both extremely promising and extremely expensive: for some, prohibitively so.

Health care costs are rising, and the new year will undoubtedly bring new challenges and more transformations. How do employers stay ahead of changes and keep costs low for our employees?

According to a study published this month, physicians estimate that 20.6% of overall medical care is unnecessary. Researchers from Harvard Medical School and Johns Hopkins University School of Medicine interviewed 2,106 doctors from across the United States, asking them about the prevalence and causes of overtreatment.

Accountable care organizations (ACOs) are being considered as one the key strategies in the next frontier of efforts to improve health care delivery and control health benefit costs. Roughly one in four large employers plan to pursue an ACO strategy in 2017 and that number is expected to grow in the coming years. However, employers have many questions about how ACOs deliver value better than the network models they offer today. To help employers better understand and evaluate ACOs in their markets, two groundbreaking tools have been released by the National Business Group on Health.

The Business Group is pleased to roll out a Public Policy Issue Brief that offers public policy recommendations to create a more favorable environment for financial sustainability and affordability of specialty medications. At the outset, understanding the challenge is important.  With specialty drug expenditures trending at an all-time high and all indicators pointing to sustained increases over time, employers are strategizing on how best to manage growing pharmacy expenditures for this subset of drugs. 

It’s important that a governance structure for benefits be in sync with the overall mission and goals of a company. What is at stake, among other things, is a company's fiscal health. Employers want to secure their employees’ health and well-being consistently across their operations in different local and global markets.

Patient (or “copay”) assistance programs and coupons present a bit of a double-edged sword. While they help facilitate payment for certain drugs, they also complicate the payment process immensely. Both help patients ultimately gain access to expensive drugs that otherwise may not be affordable. However, the intention behind each approach differs considerably, as does the overall impact.