The Healthcare Labyrinth

68. Lessons From Oz: What Does The Future CMS Head Tell Us About Trump Healthcare Policy?


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At Dr. Oz’s confirmation hearing, we learned a great deal about the Trump administration’s views on Medicare drug price reform and Medicare Advantage. Spoiler: it is not what you might expect.   About The Podcast:   Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.   Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.   Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.   Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.   Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.   About The Episode:   On this episode, Marc discusses Dr. Mehmet Oz’s confirmation hearing. We learned a great deal from the future CMS leader about the Trump administration’s views on Medicare drug price reform and Medicare Advantage. Spoiler: it is not what you might expect.   Key Takeaways:     Dr. Oz’s confirmation hearing most assuredly means he will be the next CMS leader.   Because the Trump administration closely controls the process, what is said is a good indication of what policy may be.   On Medicaid, Oz toed the Trump line and did not commit to fighting Medicaid cuts. He did say he wants to focus on waste and work requirements rather than more extensive coverage reductions.   Oz was silent on his view of extending enhanced premium subsidies in the Exchanges.   Oz did endorse Medicare drug price reform and the current law and said he would defend it in court from Big Pharma suits.   He also said he was open to international reference pricing.   Oz endorsed pharmacy benefits manager reform as well.   Oz has been an ardent supporter of Medicare Advantage but now says it needs reform.   He committed to tackling risk adjustment abuse and overpayments.   He criticized prior authorizations and denials and wants radical reform and restrictions here.   He also wants marketing reform and to return more of the rate rebate to the government rather than additional benefits.   Connect with Marc   Marc on LinkedIn Marc on Twitter THL Podcast   Resources   THL’s Newsfeed THL’s Blog The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
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The Healthcare LabyrinthBy Marc S. Ryan