Real-time price transparency is also policy priority for California this year. Asm. Nazarian introduced the Patient Choice and Transparency Act (AB 752) in February 2021. This measure would require commercial payers and pharmacy benefit managers (PBM) in California to provide patient eligibility information to prescribers in real-time, delivered in industry-accepted standards.
Tennessee is following suit. State Sen. Shane Reeves (R-Bedford) is carrying a similar price transparency bill, with healthcare industry experience behind him. His family has been in the pharmacy industry for 120 years. As a pharmacist, Reeves said he looks for three things in healthcare policy: quality, access and choice for the patient.
“The transparency part of the bill, I think it could change the way people shop for their pharmaceutical needs,” Reeves said. “Transparency is an essential leg of the stool in creating a free market approach in healthcare and pharmacy in the country.”
These policies could open pathways for more patient-facing tools to improve choice and access both in the provider’s office and remotely. Incoming interoperability measures, such as those outlined in the ONC 21st Century Cures Act Final Rule, lay the path for improved data liquidity throughout the healthcare ecosystem, while maintaining patient privacy.
As a former healthcare worker, Joan recognized what these policies could mean for the patient-provider relationship.
“That way the patient knows right then and there, sitting with the doctor, what their copay is going to be … so when the patient leaves, they know what they’re in for,” Joan said.
Nazarian was quick to mention patients with socioeconomic challenges like the migrant laborers Joan worked with. The California bill has the potential to save patients valuable time and money by presenting all available options during the appointment.
“This is one of those unique circumstances where I think a lot of folks are on the same side of the issue,” Nazarian said. “It all around helps … everyone to be armed with the same information. And I think that will go a long way in also helping the system flow better.”
Even with a financial plan in place, patients can still find surprises at the pharmacy counter.