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Part B Reference Pricing Faces 'Clinical' As Well As 'Political' Obstacles

 
• By Cathy Kelly

Medicare pilot program on value-based purchasing could be challenged by a lack of therapeutic consensus as much as by opposition towards reduced reimbursement.

The Centers for Medicare and Medicaid Services would face significant clinical as well as political obstacles to experimenting with reference-based pricing in the Medicare Part B program, policy experts predicted at a recent public forum sponsored by The Pew Charitable Trusts.

Reference pricing is among a number of possible value-based payment approaches included in a recently proposed Part B payment demonstration,...

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