It’s all about the money
With full Obamacare repeal dead in Congress, health policy shifted significantly to the executive branch.
Alex Azar, who took the reins of HHS and its $1.2 trillion budget as secretary in January 2018, charted a course of significant changes to the system: through an overarching strategy to lower drug prices and claw back money from the hospital industry.
Azar initially faced skepticism from critics who argued his tenure as a top executive with pharmaceutical giant Eli Lilly & Co. could blunt the Trump administration’s promised plan to lower drug prices. That didn’t abate when the White House in May unveiled its blueprint. But as the policy bones gained muscle, Azar’s ideas have won over some doubters and drawn ire from manufacturers.
Among the most controversial policies: a mandatory International Pricing Index Model for Part B physician-administered drugs to align prices with those in other countries. The administration also made a pitch for price negotiations for drugs in protected classes, where Medicare costs are exceptionally high.
On the hospital side, HHS sparked industry anger over its efforts to rein in spending. The CMS finalized a rule that will slash payments for office visits at hospital outpatient clinics to match the rate for independent physicians’ offices. It also trimmed the 340B drug discount program. Hospital groups have turned to the courts to try and reverse what they deem to be administrative overreach.