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> More of a federal Medicare problem because the government runs an insurance plan that fails to throw its heft around and negotiate beyond “you can’t charge us
by chimeracoder 3y ago
> More of a federal Medicare problem because the government runs an insurance plan that fails to throw its heft around and negotiate beyond “you can’t charge us more than other insurers”.
You've got it backwards. Medicare does negotiate, in some cases reimbursing less than COGS. Hospitals and providers make up for it by charging private insurers more (that's why private insurance contracts always state that they reimburse X% of the Medicare Allowable Rate, where X > 100).
- Scoundreller 3y agoLooks like it’s only starting for drugs in 2026. But until now, they paid whatever list price the manufacturers dreamed up: > For the first time in history, Medicare will have the ability to negotiate lower prescription drug prices because of the Inflation Reduction Act https://www.hhs.gov/about/news/2023/03/15/hhs-releases-initial-guidance-historic-medicare-drug-price-negotiation-program-price-applicability-year-2026.html https://www.hhs.gov/about/news/2023/03/15/hhs-releases-initi...
- chimeracoder 3y ago> Looks like it’s only starting for drugs in 2026. But until now, they paid whatever list price the manufacturers dreamed up: We're not talking about prescription drugs - the entire thread so far has been about inpatient and outpatient care. Medicare does not negotiate prices for prescription drugs at the moment, but that's because pharmaceutical coverage for Medicare is provided by private insurers, and those private insurers are responsible for negotiating the rates.
- digikata 3y ago10 drugs out of probably tens of thousands.