Policymakers frequently target pharmacy benefit managers (PBMs) in a well-meaning attempt to contain rising drug prices, but some proposed changes could have the opposite effect for patients. AMCP encourages PBM reform efforts to focus on common-sense requirements for transparency reporting by PBMs. It’s time for a more nuanced discussion about PBM reform—one that lowers the temperature and puts patients first.

Prescription digital therapeutics (PDTs) are software-based therapies shown to benefit those with mental health conditions like depression. However, many PDTs do not currently fit into one of the statutorily defined coverage categories for the Medicare or Medicaid programs, leaving beneficiaries of those programs—which include some of America’s most vulnerable populations—without access to these effective and accessible treatments. AMCP supports the Access to Prescription Digital Therapeutics Act, an important bipartisan bill that would help remedy this disparity by creating a comprehensive benefit category and expanding Medicare coverage to include PDTs.

Signed into law in 2022, the Inflation Reduction Act (IRA) ushered in Medicare prescription drug pricing reforms and imposed caps on out-of-pocket expenses for Part D beneficiaries. While much discussion and analysis has focused on how the IRA will impact Medicare beneficiaries, Part D plans, and government spending, the impact of the legislation will extend to stakeholders across the U.S. health care industry.

Value-based payments (VBP) systems incentivize providers to improve patient outcomes, reduce costs, and improve the overall patient experience, making them a critical tool for promoting high-quality, affordable care. However, defining and measuring the value of a drug can be complex, especially when considering factors like clinical outcomes, patient characteristics, and population health. AMCP supports the Medicaid VBPs for Patients (MVP) Act to modernize the framework for value-based purchasing arrangements in Medicaid, ensuring that the proper channels exist to connect Medicaid patients with the therapies they need.

This infographic highlights the key benefits of being a member of AMCP for managed care professionals (a.k.a. MCPs) in different career settings.