Access to health care "Increasingly limited competition in certain health care markets often is leading to unsustainable price increases and fewer choices for patients and consumers," says AHIP's Matt Eyles.

Our health care system may have survived the strain of the pandemic, but it hasn't come out unscathed. Burnout and stress are driving many professionals from the industry and creating access issues, while labor and supply costs are driving up costs. Stakeholders must act quickly to ensure that consumers can continue to get the care they need, without breaking the bank.

To help stem the tide, America's Health Insurance Plans on Tuesday announced a policy roadmap aimed at improving health care access and affordability.

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"The effort is focused on boosting competition in health care markets and reining in harmful practices that hurt American families," according to the organization. "With the launch of this policy roadmap, AHIP sent letters to President Biden and the leadership of Congress that lay out a detailed set of legislative and regulatory enforcement actions to increase competition in health care, drive down costs and improve health care access for patients."

The Healthier People through Healthier Markets proposal targets 10 key areas:

  1. Support consumer-centric expansion of home-based advanced care through value-based care and payment models.
  2. Bring much-needed transparency to private equity firms' monopoly power in air ambulance, emergency and certain specialty services.
  3. Advance site-neutral payments to defend consumers against having to pay more for the same services depending on the site of care.
  4. Support patients' choice of telehealth when clinically appropriate.
  5. Address the harms caused by the dialysis duopoly by preventing its further expansion, removing barriers to care alternatives that are better for patients and curbing the use of charitable structures that redirect resources to fortify the duopoly.
  6. Stop consolidated health systems from using their monopoly position to stifle negotiation and innovation.
  7. Accelerate the availability of prescription drug biosimilars.
  8. Stop drug manufacturers from engaging in patent games that distort the system to maintain monopoly profits.
  9. Reform the system for provider-acquired drugs.
  10. Address the ways in which drug manufacturers have abused charitable structures to protect their monopolies rather than help patients.

"When robust competition exists in our health care system, negotiations between private-sector entities work to encourage innovation, quality improvements and more affordability," said Matt Eyles, president and CEO of AHIP. "But increasingly limited competition in certain health care markets often is leading to unsustainable price increases and fewer choices for patients and consumers.

"The status quo is unaffordable for many American families and businesses, and that is why we're putting forth meaningful solutions that will promote greater competition and access while improving affordability."

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Alan Goforth

Alan Goforth is a freelance writer in suburban Kansas City. In addition to freelancing for several publications, he has written a dozen books about sports and other topics.