Blogs

Meeting #7 of the Blue Ribbon Commission was held on Thursday, February 6th in Shoreview. The information that we are receiving is incredibly helpful in understanding the complexity of both DHS and MDH.

We kicked off the meeting with a presentation by DHS’ Health Care Integrity and Accountability Division on third-party liability and competitive price bidding. Many, including some legislators on the BRC, learned for the first time that there is a Health Insurance Recovery Unit at DHS that focuses entirely on discovering whether other insurance is available before someone is enrolled in Medicaid.

We got a history lesson on Medicaid population focused managed care organizations (which are health plans and county-based purchasers) and the process that DHS and MDH undertake when looking at competitive bidding proposals.

Next up, we took a deep dive into the murky pool of pharmaceutical spending. Minnesota spent $5.2 billion in 2017 on retail prescription drugs which was a 30.8% increase since 2012, and a 1.3% increase since 2016. Pharmaceutical spending is one of the largest cost drivers in overall health and human services spending in MN. So it’s not surprising then to see three pharmacy-related strategies brought forward for the BRC consideration. Those included:

• Uniform pharmacy benefit in public healthcare programs

  • Goal: DHS administers the pharmacy benefit for Medical Assistance beginning in Jan 2022. Cost reductions are expected, increasing transparency and pricing and operations. We’d rely on the State’s preferred drug list process.

• Pharmacy pricing: Prescription drug purchasing council

  • Goal: Establish a legislatively chartered group comprised on officials from across applicable state agencies, counties, cities and other public entities and charge them with wrapping their heads around prescription drug spending, finding was to increase MN’s leverage of drug benefit purchasing power within existing statutory authorities.

• Pharmacy pricing: Establish a prescription affordability commission

  • Goal: Establish a Prescription Drug Affordability Commission to look at the issues related to affordability of medicines.

Going Forward: Upcoming BRC meetings will focus on long-term supports and services, which gets to our industry. I’ve been meeting with a select group of ARRM board members to discuss the strategies that have been submitted and that fall into our space. We are also meeting with DHS next week to understanding their thinking on some of the proposal submitted. Stay tuned for my next blog post.

Remember, the BRC is gathering information at this time and discussing whether the various strategies submitted thus far make sense to investigate further. We are not making recommendations yet. We will do that in July and August with the full report due to the Legislature in October. Between now and July there will be ample time for ARRM members to offer your thoughts on the proposals throughout early to mid-2020. We will let you know how you can make your voice heard. Click here to review the BRC charge and timeline of activities.

If you’re a data-driven person, check out this slide deck. I have found this document to be particularly helpful thus far in explaining health care spending and trends.