Medicare Pricing & Contracting Conference

This week, Informa Connect – CBI held their Medicare Pricing & Contracting conference in Alexandria. One of the best things about this conference was the variety of the speakers who shared different perspectives from pharma, think tanks, advocacy organizations, and pharmacy benefit managers. I shared some resonating sound bites on Twitter, but every speaker came very prepared with relevant, timely content.

Much of the discussion surrounded the future for Part D, with a number of redesign proposals on the table in Congress. We also heard about physician payment policy, including some 2021 changes in documentation requirements and increased payments for certain office/outpatient evaluation and management visits.

From the beneficiary perspective, we heard some statistics on Part D prescription use, income, and general savings. With unarguable growth of Medicare Advantage (MA), so grow the expenditures. Audience members were keen on understanding how to best control costs for long term stability.

We are in the dawn of benefit design which can impact social determinants of health, or SDOH. Factors such as physical environment, level of family support, diet and exercise, and availability of community offerings should all be considered by MA plans. How to pay for these items was another discussion in itself.

On a personal note, it was fantastic to learn from people representing different industries. I shared with attendees that joining the board of a federally-qualified health center gave me an appreciation and an education on how payer decisions and legislation affects a provider. Attending this conference which was geared heavily towards pharma was an equally beneficial learning experience, so I am looking forward to the next one.