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The groups supporting the legislation say that large health systems use their size to enforce anti-competitive contracts.

"The total spend on 340B purchases grew from $12.2B in 2015 to $43.9B in 2021," says Sarah hearn.

"Moving ahead, enrollee cost sharing for COVID-19 tests in a clinical setting will depend on their health plan and where they receive a test," researchers say.

The report notes that by 2021, brand name prescription drugs accounted for only 14% of utilization but more than 80% of spending.

Facility fees are rising out-of-proportion to other costs, including the cost of emergency physician services.

With health care spending projected to reach $7 trillion by 2030, RBP pricing can deliver cost savings for self-funded plans, but comprehensive auditing is required.

The 2020 law, which allows for price transparency in medical billing, has been largely successful in protecting consumers, though gaps remain, say stakeholders.

With health care spending expected to increase 10% in the next three years, the case for reference-based pricing is growing, while employers with at least 100 employees should also be looking at self-funding.