John C. Goodman – Page 10 – The Goodman Institute Health Blog

Consequences of Medicare Out-of-Pocket-Cost Sharing for Drugs

Posted on August 2, 2024August 2, 2024 by John C. Goodman

First, patients stop taking drugs that are both ‘high-value,’ and suspected to cause life-threatening withdrawal syndromes when stopped.

Second, we identify patients at the highest risk of drug-preventable adverse events. Contrary to the predictions of standard economic models, high-risk patients (e.g., those most likely to have a heart attack) cut back more than low-risk patients on exactly those drugs that would benefit them the most (e.g., statins).

Third, patients appear unaware of these risks. In a survey of 65-year-olds, only one-third believe that stopping their drugs for up to a month could have any serious consequences.

We conclude that, far from curbing waste, cost-sharing is itself highly inefficient, resulting in missed opportunities to buy health at very low cost (⁠$11,321 per life-year).

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Paragon’s proposals for Medicaid Reform

Posted on August 2, 2024August 7, 2024 by John C. Goodman

1. Starting in 2026, the 90% federal match for the expansion population would be phased down until it is level with each state’s traditional enrollees in 2034. States would still be able to maintain the expansion population, but with a new cutoff of 100% poverty — while those earning more would be eligible for ACA plans.

2. The minimum amount of spending covered by federal dollars would be reduced from 50% to 40%, also starting in 2026 and ending as of 2034… Wealthier states, like New York, California and Massachusetts, would have matches rates between 45% and 50%.

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