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The Abstract
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> By Torie Ludwin, Arnold Ventures
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Here's one more reason to support site-neutral payment: It saves patients money, says Evan Mintz, director of communications.
The fight against cancer isn’t just about treatment and recovery. Along with the emotional and physical burden, there’s also the financial struggle. For many, a cancer diagnosis comes with an unsparing dual reality: the fight for one’s life and the daunting challenge of managing the subsequent cost of treatment.
Not everyone survives this part of the cancer battle unscathed. One in four Americans with medical debt who have had cancer have declared bankruptcy or lost their home. Two-thirds have cut spending on food, clothing, and other household spending.
However, a proposed bipartisan law working its way through Congress — the Lower Costs, More Transparency Act — will help put money back in the pockets of Americans who need it the most.
New research supported by Arnold Ventures has found that if the law had been in place in 2021, chemotherapy patients would have paid $292 less in cost sharing. And the highest-need chemotherapy patients would have paid more than $1,000 less.
The law works by expanding site-neutral payment in Medicare. It would require Medicare to pay the same amount for drug administration services provided in off-campus, hospital-owned facilities as it pays when the same service is provided in a doctor’s office.
This policy is a necessary push against the all-too-common practice of large hospital systems buying up independent physician’s offices and converting them to hospital outpatient departments. Those facilities can then charge higher hospital prices — and tack on an extra facility fee — for services that are safely and regularly provided in a doctor’s office. Patients end up paying more for the same routine services, even when they’re seeing the same doctor, because of the location where the services are provided.
A coalition of Republicans and Democrats are working to close this loophole. The Lower Costs, More Transparency Act is a small but necessary step toward ensuring that the same service means the same price. Our research shows shows it will deliver critical savings for cancer patients and their families.
Read our story>
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Reversing Course at the FDA
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By Erin Jones, health care manager
How long should it take the FDA to undo a call made too soon? Arnold Ventures is taking a look at the consequences of patient exposure to drugs that fail their confirmatory trials for the FDA.
What Happened: PEPAXTO, a drug intended to treat a blood cancer called multiple myeloma, received accelerated approval from the FDA in 2021. However, post-approval confirmatory clinical trials failed to verify clinical benefit of PEPAXTO for patients, and available evidence raised concerns about the drug's safety. AV observed that more than two years passed from the time the FDA alerted the public of an increased risk of death associated with PEPAXTO to the FDA’s withdrawal request of the drug.
Why It Matters: When available evidence demonstrates a drug is not shown to be safe or effective under its conditions of use, the FDA must develop and use procedures to withdraw approval of that drug expeditiously. There are financial and physical consequences to patient exposure to accelerated approval drugs that fail their confirmatory trials, and health care dollars should be directed toward interventions that have meaningful evidence documenting their safety and efficacy.
What’s Next: AV has requested that the FDA further describe the expedited withdrawal procedures that will be used in the future and address ways to make the process timelier than the one used for PEPAXTO. In November, an oncology advisory committee meeting will be held to in part to discuss two other oncology drugs that received accelerated approval that have also not met their agreed-upon milestones for completion of confirmatory trials.
Read our letter>
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A Financial Value Transparency Framework for Higher Ed
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By Evan Mintz, director of communications
Picking the right college can be tricky. A new transparency framework by the Department of Education will help students and families make smart choices — and help researchers and lawmakers craft evidence-based policies.
What Happening: The Department of Education has finalized its Financial Value Transparency framework. This framework and an associated website will provide critical data to prospective students on measures like students’ likely earnings after graduation, median student loan debt, and the total cost of tuition, fees and other expenses.
Why It Matters: “The Department’s forthcoming program information website will provide prospective and current students with more information than ever before about program costs and outcomes at all institutions,” the Postsecondary Data Collaborative, which includes Arnold Ventures, said in a letter of support. “Moreover, the new information will help inform data-driven decision-making among educational institutions and policymakers at all levels — ultimately enabling students to reap greater benefits from their postsecondary investment.”
What’s Next: The initial deadline for colleges and universities to report their data is set for July 31, 2024. Until then, the Collaborative is encouraging the Education Department to provide guidance and outreach efforts to ensure a timely implementation of the new reporting requirements, and also to develop a clear timeline for launching the new program information website.
Read the Collaborative's letter of support>
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$5.6 million
Amount that El Paso County, Texas, has saved by reducing unnecessary pretrial detention.
Investing just $250,000 a year to collect and analyze data has helped El Paso County, Texas, reform its pretrial system, leading to cost savings and improved outcomes. In addition to the money the county has saved, there have been reductions in the time people spend in jail before trial, a large decrease in missed court appearances, a fall in re-arrest rates for higher-risk cases, a drop in incarceration rates for people charged with less-serious misdemeanors, and an increase in pretrial detention for people charged with violent felonies and capital crimes.
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Criminal Justice
- KSTP-TV in Minneapolis covers a decision by the Ramsey County Board to provide $2 million for a pilot program that will experiment with reforms to the current money bail system.
- The AP reports on how the American College of Emergency Physicians (ACEP) has issued a statement withdrawing its approval of a 2009 paper endorsing the pseudoscientific diagnosis of “excited delirium” in cases of fatal police encounters. Additionally, The New York Times has a story on how California has become the first state to bar the use of excited delirium and related terms as a cause of death in autopsies. (free link)
- A new report from The Sentencing Project details how policy reforms in recent years have helped to reduce incarceration and racial disparities. However, despite these gains “imprisonment levels remain too high nationwide, particularly for Black Americans.”
Health Care
- An op-ed in the Buffalo News calls for site-neutral payment policies that will save billions for “the federal government to private insurers to enrollees.”
- NPR picked up the recent Tradeoffs story about the challenge of navigating deceptive Medicare marketing tactics — particularly for the roughly 12 million Americans who qualify for both Medicare and Medicaid.
- Republicans and Democrats on the Senate Finance Committee are scrutinizing Medicare Advantage brokers for selling private information and aggressively pitching plans that may be a poor fit, STAT News reports.
- Premiums for employer-sponsored family health coverage rose 7% this year, reaching $23,968, with workers on average paying $6,575 toward the cost of their coverage, KFF found in its annual employer health benefits survey.
Public Finance
- Eric Toder of AV grantee the Tax Policy Center discusses the potential consequences if the Supreme Court rules the taxation of unrealized income unconstitutional in Moore v. United States.
- A new report from AV grantee the Committee for a Responsible Federal Budget discusses budget reform options as we approach the 50th anniversary of the Budget and Impoundment Control Act of 1974.
- Thirteen states will integrate their state tax filing systems to participate in the IRS’ Direct File pilot program next year, reports Katie Lobosco for CNN.
Higher Education
Infrastructure
Evidence-Based Policy
- The State Higher Education Executive Officers Association (SHEEO) recently kicked off a new partnership, including five $50,000 grants, to help states replicate the evidence-based program for student success, CUNY ASAP|ACE.
- AV grantees J-PAL and Results for America recently announced 18 new partnerships with state and local governments, aimed at helping agencies rigorously evaluate their programs and utilize existing evidence in deploying federal pandemic recovery dollars.
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The Catalyst podcast with Shayle Kann looks at how U.S. industrial policies like the CHIPS and Science Act and the Bipartisan Infrastructure Law are actually affecting investment in climate technology like hydrogen, carbon management, renewable energy, and other fields. |
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Have an evidence-based week,
– Torie
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| Torie Ludwin leads strategic branding efforts across digital, print, and multimedia, including this delightful newsletter. |
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