- - Tuesday, June 26, 2018

ANALYSIS/OPINION:

Before closing, I want to touch on the role your organizations can play in another of our top priorities at HHS: combating the opioid crisis. … I’m not sure many caregivers for the elderly ever expected to have to tangle with drug addiction.

For instance, one of the most common causes of hospitalization for seniors in America is a hip fracture, and hip fractures are extraordinarily painful. In many cases, treating them with opioid painkillers is appropriate and necessary. But discharging patients from a post-acute care facility while on an opioid regimen can be risky.

Opioids are often not the best long-term pain management option and they carry the risk of creating dependence or addiction. For elderly patients, there is also a real risk of these pills being diverted for others to abuse. We have to do our very best to ensure seniors receive appropriate, effective pain management throughout the continuum of care, and in many cases that means appropriately tapering opioids treatment before discharge.

The opioid crisis has been a top priority for President Trump. Advancing the practice of pain management, in fact, is one of the five pillars of the HHS strategy for the opioid crisis we unveiled under this administration.

Developing new, effective pain treatments, which are such an important priority for an aging population, is going to be a focus of a new public-private partnership at the National Institutes of Health, funded thanks to the 2018 government funding bill signed by President Trump earlier this year.

This is just part of a much broader set of accomplishments we have seen under President Trump that will benefit the older Americans you serve.

In the first 500 days of this administration, which we marked yesterday, President Trump has taken significant steps to make American healthcare more affordable and our government more accountable.

Last month, the President rolled out the most ambitious plan for reforming drug pricing of any president — a sweeping agenda for boosting competition, expanding and improving Medicare negotiation, creating new incentives for lower list prices for drugs, and bringing down seniors’ out-of-pocket costs. We are proud to have already taken action since then, with the FDA taking new steps to promote generic competition and CMS putting pharmacy benefit managers on notice about gag clauses that could be driving up costs for Medicare Part D patients. These actions follow a record-breaking year for generic approvals at the FDA, as well as a change to how Medicare pays for Part B drugs that will save our seniors hundreds of millions of dollars in out-of-pocket costs each year.

Meanwhile, CMS has been taking action on the broader value-based agenda I’ve described today, putting patients first, reducing paperwork burdens, and promoting transparency. We’ve also proposed to open up new options for more affordable insurance in the individual market. We have taken new steps to protect the conscience rights of religious health providers, so many of whom play an important role in our long-term care system.

I want to conclude today by laying out why I’m so optimistic that there is much more positive change to come.

I believe we will look back on this presidency as an inflection point in the journey toward a system that delivers better, cheaper healthcare, by paying for value rather than procedures.

Why is that? First, the status quo cannot hold. With the demographic shifts our country is undergoing, the way we do business in American healthcare has to change.

We also have a president who is unafraid to drive the changes we need. The President has seen and heard how the high cost of healthcare is burdening so many Americans, especially our seniors, and he has given us a mandate to do something about it.

Some of the necessary changes won’t be so comfortable for entrenched players. But those who are interested in working with us to build a new system will have unprecedented opportunities at hand.

As I said earlier, the changes we are seeing in our country’s demographics represent an opportunity. The same is true of this President’s reform agenda. So I exhort all of you to engage with us on the issues I’ve discussed today and take advantage of the opportunities they represent. Because under this President, in American healthcare, change is coming.

These remarks are excerpted from Secretary Azar’s June 5, 2018 speech to the American Health Care Association/National Center for Assisted Living in Washington, D.C.

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