As Vice President for Policy and Federal Affairs, Mary Ann Chaffee leads Surescripts efforts to help inform federal healthcare policy. It’s a natural fit, as she’s no stranger to the halls of Congress, having worked to advance public health policy as a legislative director for two U.S. senators. As adventurous as she is intellectually astute, she’s also lived in Uganda, moving there shortly after the end of the country’s civil war. From 1998 to 2000, as part of a USAID project, she helped Uganda’s first freely elected parliament establish a research staff, a budget office and draft legislation that created parliamentary oversight of the executive wing. I recently sat down with Mary Ann to talk about the healthcare hot topic that’s giving the buzz over interoperability a run for its money: price transparency.
1. As consumers face ever-increasing costs for medications, policy makers at both the state and federal level have taken up the cause of price transparency. But the term can mean many different things in the world of healthcare. When you have a coffee with peers who are involved in price transparency efforts, what trends or advances are you talking about lately?
At the federal level, dozens of bills related to drug price transparency have been introduced in the current Congress, but none have made it to the finish line. At the state level, it is a very different story. With bipartisan support, 24 states have passed 37 bills just this year to address prescription drug transparency and costs. What does that mean? When policymakers talk about drug transparency, they are really talking about reducing overall spending for drugs and aligning drug prices with value. Price transparency is just the first step to achieving those goals. As an example, some states are requiring insurers or drug companies to disclose drug prices and to justify price increases in excess of a statutory benchmark, such as 20 percent in a single year or 50 percent over 3 years. Under these new laws, state governments will be using their purchasing power and regulatory authority to control drug costs for private and public patients and purchasers. Requiring price disclosure as a first step helps educate the public and build support for such reforms. It’s shocking to think we're spending almost 20 percent of our GDP on healthcare and there’s no simple or fast way to rein that in. These legislative efforts are important steps.
The work we’re doing at Surescripts is price transparency in action. Our benefit optimization technology delivers patient-specific benefit, price and therapeutic alternative information in real time. The prescriber and patient can now have an informed conversation in order to choose the most appropriate and affordable medications. I’m not sure there’s any other technology or product that does the same thing with regards to looking at actual and relative cost at the point of prescribing. Regulators at the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicaid & Medicare Services (CMS) have also been very excited about our solution. What’s more, under appropriate circumstances, we may be able to look at data about how this technology impacts prescribers’ behaviors, which could help policymakers and researchers make more thorough, honest and informed policy deliberations.
2. How would you talk about prescription price transparency at a cocktail party?
Most everyone has had an experience of arriving at the pharmacy and learning that a prescription is going to cost much more than they anticipated. It’s an instant “get”. Explaining the work we’re doing to advance prescription price transparency—and why it’s needed—is far easier than explaining, say, how Blockchain could further interoperability. I could do it, but everyone would want to top off their cocktails first.
3. Not counting colleagues at Surescripts, who do you consider influencers, innovators or leaders in the healthcare field?
I follow the work of the National Academies of Sciences, Engineering and Medicine. It’s a non-political organization comprised of scientists and policymakers who’ve done groundbreaking and incredibly influential work. People still reference the report they produced linking hospital deaths to medical errors, “To Err is Human: Building a Safer Health System”. They also produced an excellent report last fall on the forces that influence drug pricing. The RAND Corporation is also doing some interesting work that’s not specifically related to health or transparency, but rather looks at the way we use –or don’t use–data to make decisions. Their analysts are exploring why the public is being encouraged and more inclined to substitute opinion for data, to question evidence, to substitute personal experience for evidence. They call it truth decay.
4. Who or what inspires you?
Ruth Bader Ginsburg, who beyond her accomplishments as a brilliant advocate and Supreme Court Justice, is an inspiration to women of all ages (see the Notorious R.B.G.) and, at age 85, can do more pushups than I can.
5. It's 2028. What are you most proud of having helped accomplish in healthcare?
I remain most proud of my work in public health. I’ve been fortunate to work on legislative efforts to prevent infant mortality, to create nutrition programs for needy children, to secure funding for global polio eradication. To be part of something that's not politically fraught, and that for relatively small investment, creates incredible good in people’s lives, that's very satisfying.
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