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For the kinds of big employers that respond to surveys, prescription drug cost issues dominate the list of top policy priorities.
Analysts at the National Alliance of Healthcare Purchaser Coalitions reported that finding in a summary of results from a recent survey of 324 employers. About 83% of the employers came from organizations with 500 or more workers.
The alliance represents groups that help employers work together to improve the cost and quality of health benefits.
The National Alliance survey team found that their survey participants see drug prices as the top health care affordability threat: 86% classified drug prices as a "significant threat."
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The percentage of participants identifying possible cost concerns as significant threats was 76% for hospital prices, the cost driver that ranked second, and 73% for high-cost claims.
Only 23% classified the lowest-ranked concern, "broker/broker conflicts of interest," as a significant threat.
The National Alliance also asked the participants to rank public policy priorities. The list of 11 candidates did not include protecting the group health tax exclusion.
Pharmacy benefit managers tied for first on the list of policy priorities that were included on the list with "drug price regulations."
About 56% of the participants said PBM rule changes and drug price regulations, such as drug price caps, would be very helpful to their plans.
Protecting Employee Retirement Income Security Act preemption, or the federal law that prevents states from regulating large, multistate employers' health benefits, ranked third, with 58% saying protecting ERISA preemption is very important to their plans.
The priorities in the fourth, fifth and sixth slots were all related to hospitals. The share of participants classifying those items as very important was 40% for hospital price transparency, 38% for hospital rate regulations and 37% for addressing efforts by hospitals to limit competition.
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