Lynn Barr, the founder and executive chair of a company that helps health systems implement value-based payment models and maximize 340B savings, has been appointed to the Medicaid Payment Advisory Commission (MedPAC).
U.S. Comptroller General Gene Dodaro announced Barr’s appointment to a three-year term as a MedPAC commissioner on June 2, along with that of Stacie Dusetzina, Associate Professor of Health Policy and Ingram Associate Professor of Cancer Research at Vanderbilt University Medical Center. Dusetzina researches and publishes often on prescription drug pricing and reimbursement.
MedPAC advises Congress on issues affecting Medicare. The commission has been paying closer attention to 340B of late as Medicare Part B drug spending has grown and shifted more toward hospital outpatient departments. In 2016, it advised Congress to reduce Part B drug reimbursement to 340B hospitals by 10% and redistribute the savings among all Medicare-funded hospitals based on their uncompensated-care spending. The Trump administration turned MedPAC’s recommendation into its nearly 30% percent cut in payments to 340B hospitals, which began in 2018 and remains in effect.
Barr created Caravan Health (a 340B Report sponsor) in 2013 mainly to help rural hospitals and health systems create and benefit from accountable care organizations (ACOs). The 2010 Affordable Care Act (ACA) gave health systems and other providers a financial incentive to collaborate to improve Medicare beneficiaries’ health outcomes. ACOs that that meet or exceed certain quality measures share in savings they achieve for Medicare.
The ACA meanwhile extended eligibility for 340B drug discounts to many of those same rural hospitals. Caravan Health sees ACOs and 340B as pillars of support for safety-net providers. As health systems shift away from fee-for-service to value-based payment, their revenue streams from 340B become even more important, the company says.
“I see first-hand how important the 340B program is to safety net patients and providers,” Barr told 340B Report. “I will work to preserve the program and expand it as much as possible. Healthcare policy is a series of trade-offs. Under the Affordable Care Act, critical access hospitals lost a lot of support for uncompensated care but were given 340B eligibility, which offset the losses. If 340B declines or disappears, the federal government will have to step in and provide additional support to the safety net. The Medicare Trust fund is forecasted to be insolvent in 2024 as it is, so I don’t think the government is able to take on those additional costs.” “I’m thrilled to be appointed as a MedPAC commissioner,” Barr said. “They have a brilliant team. Most of my progress in rural and safety-net payment reform has been informed by their work. I look forward to bringing a unique perspective to the table.”