AAOS Now, October 2017
Unsustainable Physician Reimbursement Rates
The United States has the highest per capita healthcare spending in the world. U.S. healthcare costs have outpaced inflation for several years. Over the past 20 years, the federal government has attempted to control costs—specifically Medicare costs. Cost reduction strategies often focus on specific segments of the healthcare market. These segments include hospitals, outpatient facilities, labs, drugs, physicians, rehabilitation, durable medical equipment, etc.
Pharmacy Benefit Managers Play Significant Role in Drug Pricing
Congress, state legislatures, and the White House are united in a quest to reduce prices for prescription drugs. As attention focuses on pricing transparency for drugs, the role that pharmacy benefit managers (PBMs) play in the pricing process is also under scrutiny. The complex nature of the prescription drug supply chain can be confusing, and the public may believe that drug companies are the primary cause of high drug prices.