State lawmakers could implement standardized model contracts for state employees, cities, counties and school districts…………..
By Doug Aldeen
This week lawmakers in the Texas state House brought in more than a dozen expert speakers to discuss how to make healthcare more affordable.
One of those experts was entrepreneur and billionaire Mark Cuban, whose Cost Plus Drugs company seeks to address affordability and access for critical medications and often comes into conflict with legacy players like pharmacy benefit managers.
He offered legislators five steps they could take to help mitigate the affordability crisis. For one, patients should be able to access drugs at the lowest possible cost, even if that’s outside of their health plan, and there should be incentives in place for them to shop around.
More interestingly, Cuban suggested that lawmakers should introduce requirements around standardized contracts for both PBMs and third-party administrators. State lawmakers could implement standardized model contracts for state employees, cities, counties and school districts.
This is a great idea.
Sunday Morning Bathroom Read Takeaway:
Mark Cuban is on to something. To take it a step further, The state of Texas could REQUIRE by statute that any state business whether it be a village, county, city, state or any other tax supported governmental entity that provides health coverage (non-ERISA plans) to its employees must use one preapproved template direct agreement with favorable fiduciary terms for all PBM and ASO contracts. Talk about a race to the bottom.
Mark Cuban’s recipe for affordability includes 5 policy changes
It would also be a great idea to mandate Texas political subdivisions to incorporate a fourth option in every public bidding process for group health insurance – Pure Reference Based Pricing whether it’s awarded or not. This forces pubic entities to recognize it’s existence as a lower cost alternative. (The 4 Options are PPO, HMO, EPO, RBP)