The Daily Rise: Tuesday, May 31

June 4: Join Us in Chicago

This week, we’re headed to the Windy City. Patients Rising Policy Director Jonathan Wilcox brings together patients and patient advocates, as well as nationally acclaimed policy, legal and medical professionals.

  • to reveal the real barriers standing between patients and the effective treatments they need, when they need them
  • to oppose policy proposals called value-frameworks that can limit or ration the care you need
  • to propose how we can work together to assure patients have access to the best, most advanced diagnostics and treatments despite these obstacles

Lunch will be provided. The full program will be recorded and available online after 6:00PM CT. Together we can get the Right Treatment to the Right Patient Right Now!

WHEN: Saturday, June 4, 12:00PM – 2:00PM CT

WHERE: Chicago Symphony Center at 220 S. Michigan Avenue, 9th Floor in Chicago.

To register your attendance, please click here.

Confirmed Panelists and Guests: 

Campaign 2016: The Patient’s Platform

All eyes will be focused on Donald Trump and Hillary Clinton at their respective conventions. Behind the scenes, party leaders will be negotiating changes to their party platforms.

Morning Consult’s Mary Ellen McIntire writes on the effort by health care advocacy groups to influence those new party platforms that will be approved by the Democratic National Committee and the Republican National Committee. The party platforms set the agenda not just for the presidential candidates, but congressional, state and local leaders.

Among the group’s advocating for a greater investment in medical innovation is Research!America, a nonprofit public education and advocacy alliance.

“It would be profoundly meaningful for the party to identify faster medical progress – with its roots in public and private sector-fueled medical innovation, a well-resourced public health system, and continuous, research-driven improvement in healthcare delivery – as a top strategic imperative for the US,” Mary Woolley, the group’s president and CEO, wrote to RNC Chairman Reince Priebus and DNC Chairwoman Debbie Wasserman Schultz, according to Morning Consult.

Let’s hope both political parties adopt clear party platforms that put patients first.

Sorry Not Sorry

Health care analyst Jeff Stier has channeled his inner Millennial.

The Senior Fellow at the National Center for Public Policy Research in Washington, D.C. believes that insurance companies are “Sorry Not Sorry” about policies that interfere with patients’ access to the right treatment.

“Insurers will tell you (if you can get them on the phone) the drug isn’t covered because it’s not on their formulary, their own list of preferred medicines,” he writes in piece published at USA Today. “Kids have a term for this: “Sorrynotsorry.” Don’t let the circular reasoning fool you.”

He adds, “As cutting edge drugs come to market, insurance companies are scrambling to find ways to justify not paying for them.”

In addition to insurance company policies that block patients from gaining access to the right treatment, Stier places some of the blame with politicians who’ve oversimplified treatment equivalents.

“Almost as bad, doctors often have to get pre-authorization before prescribing something that is on the formulary,” he writes. “The flawed justification was normalized by President Obama in 2009, when he oversimplified pharmacoeconomics, saying, “If there’s a blue pill and a red pill, and the blue pill is half the price of the red pill and works just as well, why not pay half price for the thing that’s going to make you well?”

Protecting Home Care

Speaking of prior authorizations… More than 100 members of the House of Representatives are opposing an effort to force patients to receive prior authorization for home health care. The new requirement is part of a demonstration program proposed by the Centers for Medicare & Medicaid Services.

In an open letter to the Obama administration, a bipartisan group of lawmakers warns that the proposal “would interfere with the patient-doctor relationship and would undermine efforts to move towards patient-centered care.”

“Stated simply, prior authorization of home healthcare imposes a requirement that prevents a patient from receiving home health services after the physician orders home healthcare unless and until an intermediary has reviewed and approved the order,” the group of lawmakers led by Reps. Tom Price (R-Ga.) and Jim McGovern (D-Mass.), and was signed by 116 lawmakers.“This demonstration project imposes costs on patients, providers and taxpayers. Delaying patient care while waiting for CMS to approve home health services may put patient health in jeopardy and cause patients to stay in the hospital for longer than necessary.”

We’re pleased to see lawmakers take an interest in this issue. Home care is necessary for many patients. These patients shouldn’t be forced to complete more paperwork or fight for approval after their doctor has established that it’s the right treatment.

We’re also excited that our elected officials are standing up to CMS for overstepping its authority.

Read the entire letter here.

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