Patients Rising’s Jonathan Wilcox explains value-based pricing on CNBC – Daily Rise: Monday, June 27

Patients Rising in the News

We’re having an impact shaping the conversation about health care.

Last week, our policy director Jonathan Wilcox spoke with CNBC News about Medicare’s plan to implement “value-based pricing strategies” as it slashes reimbursement rates. The proposal, which has been universally criticized, is part of the Centers for Medicare & Medicaid Services’ effort to place price before quality and access to care.

We’re glad that CNBC offered Jonathan the chance to put costs in perspective.

“Of course, costs are a concern,” Wilcox told CNBC’s Dan Mangan. “But patients and their medicines are the last place we should be cutting.”

Thankfully, patients and health providers are uniting against the proposed changes. Ted Okon, executive director of Community Oncology Alliance, told CNBC that “people should not only be concerned, they should be alarmed” about the proposed rule.

“The government is proposing, basically, an experiment on seniors’ health care,” he said.

Improving Hospice, Palliative care

A United States Senator wants to improve training in hospice and palliative care.

Sen. Sheldon Whitehouse of Rhode Island plans to introduce legislation that would create more pilot programs and Medicare fee waivers for hospice care.  ModernHealthCare reports, “It would also allow hospice and curative care to be provided to a patient at the same time and would provide for home services before a patient is homebound.”

We’re pleased to see more attention focused on better training for hospice and palliative care. There’s still a stigma to the important conversation about end-of-life care. Better training will help. But, part of this is stigma is also the result of Medicare’s payment structure, which often undervalues this important treatment.

ICER Watch: From Bad to Worse

Mario H. Lopez, President of the Hispanic Leadership Fund, says that ICER’s efforts to restrict patients’ access to treatments will uniquely harm underserved communities that already receive inadequate care.

“When it comes to quality health care, the U.S. Latino population starts out at a serious demographic disadvantage,” Lopez writes at Fox News Latino. “We are more likely to lack health insurance and face other serious hurdles to accessing quality care. And the incidence of serious disease is much higher among Hispanics than the American population at large.”

The Institute for Clinical and Economic Review, Lopez writes, will only make these problems worse by “preventing and bogging down access to these types of medicines for patients in need.”

“ICER’s methodology in determining which drugs are worth the money is reminiscent of the criticisms of the many unelected and unaccountable boards and commissions set up under Obamacare whose mission it is to “keep costs down,” but which in practice play with patient lives by deeming certain treatments and patients to be unworthy,” he explains. “Anyone who cares about health care should be aghast that ICER is intervening between a doctor’s decision to prescribe a drug and a patient’s ability to access it, especially in underserved communities.”

All patients are harmed by ICER’s efforts to reduce access and place a price tag on a patient’s life. Lopez raises an important point that people with inadequate coverage today are likely to be locked into receiving subpar care.

The Patient’s Story

Jamie Whitmore writes of how her professional mountain biking career was temporarily sidelined by cancer.

“As I watched professional sports games and the Olympics, I would often envision myself standing in front of all those people scoring the winning touchdown or crossing the finish line in first place,” she writes in a piece at the Huffington Post. “In 2008, that all changed. I was in the most excruciating pain. On a scale of 1 to 10, I was at 20.”

At the time, Whitmore was one of XTERRA’s most winningest pro’s ever with 37 career victories. Her status as a young, healthy athlete made it even harder to confront her diagnosis.

“At 31 years old, I just found out I had cancer,” she writes. “How could I, a 2004 Xterra World Champion and super health nut, have cancer?!”

Take the time to read Whitmore’s story, which reveals some of the struggles of young cancer patients, including the assumptions made by well-intended friends and family.

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