Alliance of Community Health Plans (ACHP)

While we celebrate progress, we have serious concerns about the proposed coverage expansion for weight-loss drugs due to excessive costs and limited long-term data. As ACHP President Ceci Connolly said in The Washington Post’s story: “The proposed expansion is irresponsible without further analysis and stakeholder engagement.” Our full statement is here: https://achp.pub/4fIvXrb

More than 20 million Americans rely on enhanced tax credits to keep health insurance affordable, but they are set to expire at the end of 2025 if #Congress doesn’t act. Keep Americans Covered has launched a new tool, a tax-credit comparison calculator, that allows individuals to estimate how much their monthly premium would cost both with and without an extension of enhanced tax credits. The tool considers location, household income, family size and age and provides average prices and estimated increases for bronze, silver and gold plans. Access it here: https://achp.pub/3Zz3y1i #HealthCoverage #PremiumTaxCredits #HealthEquity

The Hospital at Home program has undoubtedly grown in the past decade, providing much-needed care to individuals with disabilities and seniors in the comfort of home, but we need more time to stabilize and spread the program. ACHP has joined Advanced Care at Home Coalition and other stakeholders to urge #Congress to extend the Centers for Medicare & Medicaid Services’ Acute Hospital at Home waiver in a joint letter: https://achp.pub/3ZeOJ3V A recent The Washington Post story shows the value of receiving care at home and the potential effects of letting the waiver expire—highlighting Mass General Brigham’s impacts in the Boston community: https://achp.pub/496KPxb #HospitalAtHome #HaH #Seniors

Pharmacy Benefit Manager reform is essential to lowering costs and ensuring patients have access to the medications they need. We won't stop pushing for a system that prioritizes transparency and affordability over profits. https://lnkd.in/eXiDCwFx #PBMs #DrugPricing

From all of us at ACHP, happy Thanksgiving! We're especially grateful for everything our member plans do to improve health care in their communities.

ACHP asks the Centers for Medicare & Medicaid Services to allow for a more effective sampling methodology in the Risk Adjustment Data Validation process in support of a more reliable marketplace. It’s time to enhance accuracy and transparency in the audit system to better serve patients and improve outcomes. https://achp.pub/3AZF6g8

Medicare Advantage star ratings should be a tool for better care, not just a metric. ACHP is pushing for changes that prioritize real, measurable improvements in senior care. Learn more about our MA for Tomorrow initiative: https://achp.pub/3ACUTBf #MedicareAdvantage #SeniorCare

The Biden Administration has proposed a new rule to include weight-loss drugs in Medicare coverage, as reported by Dan Diamond at The Washington Post. While ACHP has applauded the Administration’s work towards comprehensive coverage and care at an affordable cost for seniors, we are deeply concerned with this proposal. Drugmakers command excessive prices for these treatments and current evidence does little to show long-term success for patients with obesity. The proposed expansion is irresponsible without further analysis. Read more in ACHP President Ceci Connolly’s statement: https://achp.pub/4fIvXrb #Medicare #DrugPricing #GLP1 #Obesity

With pharmaceutical costs rising, ACHP members are encouraging affordable treatments through biosimilars. By switching to effective alternatives, we can lower the overwhelming costs of prescription drugs without impacting patient safety. Read more about ACHP's drug pricing policy priorities: https://lnkd.in/eXiDCwFx #Biosimilars #DrugPricing

“There is a balance in making sure that [prior authorization] is used appropriately while ensuring patients are able to get the care they need, when and where they need it,” says ACHP’s Dan Jones, vice president for federal affairs. Recent reforms by the Biden administration and Centers for Medicare & Medicaid Services are a step in the right direction, striving to improve patient access to timely care and encouraging appropriate use of resources, but it is just the beginning. As ACHP’s CEO Ceci Connolly explains in Modern Healthcare, “There are very clearly instances where prior authorization is about safety and appropriateness and can be about spotting fraud...we need to recognize that, especially if a patient is not in a good, integrated system.” We encourage collaboration between providers and insurers to continue improving prior authorization processes and access. Learn more about the recent changes and what ACHP leadership is encouraging for the future: https://achp.pub/4hU3EaN #PriorAuthorization #ValueBasedCare #HealthPolicy