President-elect Joe Biden is set to take office with a split Congress, making any massive healthcare policy overhauls unlikely. But employers could still see some traction on a few key priorities.
According to a post from the Pacific Business Group on Health, a number of items on employers' health reform wish list could draw bipartisan interest, namely prescription drug costs, surprise medical billing and the high cost of healthcare.
During a Nov. 4 webinar with its members, which included massive companies like Walmart, McKesson and Comcast, 71% said drug pricing should be a federal priority in 2021. In addition, nearly 60% said policies addressing non-drug health costs should also be a focus.
"High health benefit costs come at the expense of core business investments and hold down wages, dampen business growth and squeeze family budgets," according to PBGH. "The COVID pandemic and the related economic recession are making this growing crisis completely untenable as unemployment soars and many employers face existential threats."
However, Elizabeth Mitchell, CEO of PBGH, told Fierce Healthcare that getting the COVID-19 pandemic under control must be the first priority.
The economic challenges posed by the pandemic will make it hard for many businesses to stay open at all, she said. Once they're stabilized, though, these healthcare concerns will come back to the fore, especially as the pandemic has made them all the more critical.
Challenges with rising costs and accessibility are the "pre-existing conditions of the U.S. healthcare system," Mitchell said.
"These have been priorities for a long time, and we have known about these problems for a long time," she said. "This is just putting them in stark relief."
Surprise medical billing is an issue where Biden could earn a win early in his presidency, Mitchell said. Congress has been gridlocked on the issue despite bipartisan support for reform due to the competing interests of health insurers and providers.
Insurers back a solution that would set benchmark rates for out-of-network care, which providers strongly oppose. Providers, meanwhile, support calls for baseball-style arbitration to mitigate billing disputes, a move opposed by payers.
Mitchell said that families are in economic crisis due to the pandemic, and providers secured billions in funding to support them through COVID-19, which could drive calls for action.
"To continue these egregious, predatory practices when families are most vulnerable is unacceptable and I think Biden could have an immediate win to protect families," she said.
Employers have also recognized the lack of movement on these issues and have begun to find ways to take matters into their own hands, according to the article.
Half of those surveyed said they intend to alter their drug formularies to eliminate wasteful spending, as did half who indicated they would invest in addressing health inequities. Additionally, 44% said they plan to enter value-based contracts to strengthen primary care.
Drug costs are an area of particular focus for these solutions, Mitchell said, along with improving quality of care through centers of excellence. Pharmacy benefit managers have not proven themselves to be particularly effective partners in addressing drug prices, she said.
"One of the things our members are interested in doing is getting more directly involved in pharmacy and Rx purchasing," she said.