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CMS Changes The Dictionary: Medicaid ‘Best Price’ Could Soon Mean Many Things

Executive Summary

Value and outcomes-based purchasing agreements could see a boost under proposed Medicaid rule that CMS says will make it easier for manufacturers to experiment different contracting structures in the commercial health insurance market. CMS says the intent of these agreements is to lower drug prices for commercial payers, but the government acknowledges this is not guaranteed, and health policy experts worry both private payers and Medicaid could end up paying higher prices if the proposal is finalized.

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