HHS secretary calls on brokers to help lower healthcare costs

WASHINGTON — Health and Human Services Secretary Alex Azar called for more price transparency in American healthcare — and said brokers can play a key role in making that a reality.

Azar said there needs to be more clarity surrounding the price and quality of care — with one of the biggest problems being surprise billing, or when a patient receives care from an out-of-network provider at an in-network hospital. Advisers need to work with officials to shed light on these issues and identify more affordable ways for Americans to access care, he said speaking at the National Association of Health Underwriters conference Wednesday.

“Just about everyone in this room knows more about insurance than 99.9% of Americans, and yet you are just as much at risk of a surprise bill as anyone else,” he said to the room of insurance agents and brokers. “I myself have been a victim of surprise billing.”

Azar said President Donald Trump was “shocked and outraged” by stories of surprise billing. Azar mentioned a recent meeting at the White House with 10 individuals who had been affected by astronomical bills — including one patient who received an $89,227 bill for a hospital stay after a snake bite.

“Shady pricing practices are a core problem in American healthcare,” he said.

Drug cost sharing is highly unpredictable, and the price of drugs is another high out-of-pocket expenditure for Americans, he added. Azar, who served as vice president for corporate affairs and communications for drugmaker Eli Lilly before joining HHS, has been vocal about drug price transparency in the past.

See also: Trump administration zeroes in on increasing competition in healthcare

He applauded the Trump administration’s blueprint to lower drug prices which advocates for improved competition and negotiation, incentives for lower list prices and lower out pocket costs. In January, the administration proposed targeting backdoor rebates on prescription drugs by encouraging manufacturers to pass discounts directly on to patients.

“All of you have no better way to know than the rest of us where the rebates negotiated by prescription drug plans really end up going,” he said.

See also: Employer groups rally behind proposed Trump prescription drug pricing rule

But some experts have argued it’s unclear if the administration’s plan to lower costs will have a significant impact on prices. Groups representing pharmacy benefit managers are among those concerned about Trump’s proposal.

JC Scott, president and CEO of Pharmaceutical Care Management Association, for instance, said recently that his group is concerned that “eliminating the long-standing safe harbor protection for drug manufacturer rebates to PBMs would increase drug costs and force Medicare beneficiaries to pay higher premiums and out-of-pocket expenses, unless there is a viable alternative for PBMs to negotiate on behalf of beneficiaries.”

The secretary said the Trump administration will continue to tackle pricing issues in healthcare. Brokers can use their expertise in insurance to make a difference in the market, he added.

“I ask you to continue to engage with us,” he said. “Work with us to identify affordable ways for Americans to access care, and identify what is driving up cost of care in the first place.”