Trump’s War On Middlemen Might Reach Well Beyond PBM Rebates

Consumers know very little about the middlemen contributing to ever increasing healthcare U.S. costs. Both middlemen like Pharmacy Benefit Managers (PBMs) and secret health insurance company contract prices with hospitals recently have been discussed by lawmakers. There have been discussions in the White House and Congress to make changes to eliminate PBM rebates and to make hospital prices with health insurance companies open and public in an attempt to drive down healthcare costs. As policies continue to change, Medxoom now provides employers and employees with valuable price and quality information before service to make better informed decisions about their healthcare needs.

From HealthLeaders:

“When policymakers say they aim to eliminate the middlemen who drive up healthcare costs, they’re not just talking about prescription drugs. “‘We’re very much eliminating the middlemen,’ Trump said from the White House lawn nearly a year ago, with Health and Human Services Secretary Alex Azar by his side.

Trump’s words portended trouble for PBMs, which make money off the rebates they negotiate with drug manufacturers. And the pressure on PBMs has been especially pronounced since January, when the administration unveiled a proposal that could effectively kill those rebates.
There’s a separate price-transparency policy idea currently under consideration on the payer-provider side. “For decades, insurance companies and powerful provider systems have succeeded in keeping their negotiated rates veiled from public view using non-disclosure agreements and restrictive contractual gag clauses.”

For patients to make cost-informed decisions about certain healthcare services, thereby unleashing the cost-reducing effects of competition, they need more information up front. That’s the idea behind the Trump administration’s push for price transparency in corners of the healthcare industry that have been shrouded behind layers of negotiated contracts.”

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