NHC applauds IOM for recommendations on how to develop EHB package

The National Health Council (NHC) applauded the Institute of Medicine (IOM) for its thoughtful recommendations to the Secretary of Health and Human Services (HHS) on how to develop an essential health benefits (EHB) package. In a statement issued from NHC, Executive Vice President and Chief Operating Officer Marc Boutin said the IOM addressed many of the same issues identified by the patient advocacy community; however, the Secretary of Health and Human Services (HHS) needs to go a step further to address the needs of patients and adopt the specific regulatory language proposed by patient organizations.

"The NHC recognizes the challenges the Department of Health and Human Services faces in crafting a standardized benefits package that is adequate for people with chronic diseases and disabilities, while also remaining affordable. What this country needs is a pragmatic health benefits package that best meets the needs of people living with chronic conditions because they drive 75% of the health care costs.

"Upon initial review of the IOM report, the NHC agrees that HHS officials need to be as specific as possible in defining a package that balances robust benefits and affordability. The EHB package must also include patient protections that address discriminatory utilization practices, unfair cost sharing practices, and continuity of care. HHS should encourage flexibility and innovation in benefit design that support patients through the use of navigation and care coordination services. In addition, the Secretary needs to address state and federal oversight of medical decision making, including the development of an exceptions and appeals process.

"We strongly encourage the Secretary to consider the specific regulatory language developed by the patient advocacy community, which goes further toward creating a flexible, adaptable, and viable essential health benefits package."