Policy and Merger Trends, Entrants, and Developments (TEDs) Foundational to 2021 Healthcare Access
Welcome to 2021, I am Elizabeth Oyekan, PharmD, FCSHP, CPHQ, Vice President—Access Experience Team, editor of All Access Newsletter. We look forward to bringing you noteworthy and important news in our Precision Value and Health bimonthly newsletter by sharing key payer insights and implications from our team of ex-payers.
2021 holds a lot of uncertainties especially with the new presidential administration and the fate of many of the previous administration’s policies, the priorities of the new administration, and the ongoing challenges of the pandemic on the US healthcare system. So in this edition, we asked our key expert ex-payers to provide insights in the 4 key areas that will be foundational to healthcare and therapy access in 2021 and the potential impact to payers, patients, and/or pharma:
- Policies and Politics—What’s in Store for Healthcare? By Ryan Cox RPh, MBA Vice President, Access Experience Team
- Mergers and Acquisitions in 2020 and implications for 2021, by Dan Danielson, MS, RPh. Senior Director— Access Experience Team
- CMS Physician Fee Schedule (PFS) Creates More Tailwinds for Telehealth and New Opportunities for Pharma in 2021, by Maureen Hennessey, PhD, CPCC, CPHQ, Senior Vice President, Director of Value Transformation
- The Latest 340B Policy Changes and the Ongoing Challenges in 2021, by Dominic Galante, M.D., Chief Medical Officer, PrecisionValue, Access Experience Team
We believe you will find these insights in All Access supportive and insightful as you continue to navigate the payer landscape. As always, please feel free to drop me a note and let me know if you have a topic suggestion for the payer team to address, and we’ll do our best to cover it in a future edition.
PharmD, FCSHP, CPHQ
Access Experience Team
All Access is a bimonthly newsletter that features key insights from our team of former payers, intended specifically for market access leaders. It is published by PRECISIONvalue.
With Joe Biden’s inauguration as the 46th president of the United States and Democrat control of both the house and senate, there are a number of policy changes anticipated. As expected, the current focus of the administration is the pandemic, bolstering the roll-out of the vaccine and providing economic support to those parts of the economy that have been most impacted, but what else? Precision’s Ryan Cox explores some of the expected policy priorities and changes for healthcare in 2021.
New healthcare policies undoubtedly mean a shift in market access. In this article, Precision’s Dan Danielson explores the high-level potential market consequences in 2 major segments of the US healthcare environment and the rationale behind each: the healthcare systems and hospitals that deliver care, and pharmaceutical manufacturers who develop new drug therapies for the patients served by the health systems.
CMS Physician Fee Schedule (PFS) Creates More Tailwinds for Telehealth and New Opportunities for Pharma
Telehealth vendors, health systems, and clinicians are seeing opportunities to further expand delivery of reimbursable telehealth services since CMS issued its (CY) 2021 Medicare Physician Fee Scale final rule on December 1, 2020. Precision’s Maureen Hennessey discussing the impact of these expanded opportunities, and how they set the stage for amping up the velocity for telehealth growth.
With the new changes in the latest CMS 340B rules and policies regarding patient access to discounted drugs, there will certainly be challenges between pharma and contracted pharmacies. Precision’s Dominic Galante discusses the potential positions that will be taken by plaintiffs, and the associated 340B Program litigation.