What payment models are the best options to allow savings? How do state Medicaid programs know if what they pay pharmacies for retail drugs and providers for physician-administered drugs is appropriate?
As states struggle with increasing prescription drug costs, they are testing various alternative payment models (APMs). Colorado is exploring a first-in-nation payment methodology for how it reimburses providers for physician-administered drugs (PADs). Colorado surveyed providers across a range of practice sites to better understand how much providers are actually paying for drugs. This survey data would inform an average acquisition cost-based payment methodology for PADs with the potential for $3.4 to $12 million in savings in the first year if implemented.
Additionally, researchers at the Johns Hopkins Bloomberg School of Public Health are studying the National Average Drug Acquisition Cost (NADAC) as a payment methodology for retail pharmacies. They are examining the effectiveness of NADAC as a tool for states and whether the use of NADAC has led to cost savings.
The webinar moderator is National Academy for State Health Policy Executive Director Trish Riley. Speakers are:
- Kevin Martin, BS, Fee for Service Rates Manager, Colorado Department of Health Care Policy and Financing
- Joseph Levy, PhD, Assistant Scientist, Johns Hopkins Bloomberg School of Public Health