Would it ever make sense to tie a part of provider reimbursement to expenditures on drugs (at least for Part B drug costs), for example under an updated version of MACRA? We include drug costs in ESRD bundles now. Further, what if we empowered physicians to work with PBMs to negotiate lower prices for drugs? Under the current ASP + 6% formula, there is no cost control measure for drug expenditures. Would it make sense to put providers directly at risk (and incorporate reference based pricing based on functional categories, for example) to help them become more cost-conscious?
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