Value is king. But in today's healthcare environment, value relies on refined quality measurements and innovative payment models.
NATIONAL REPORTS-Value is king. But in today's healthcare environment, such value relies on refined quality measurements and innovative payment models.
RAND Health recently analyzed 90 payment reform programs and performance measures. Commissioned by the National Quality Forum, "Payment Reform: Analysis of Models and Performance Measurement Implications" identifies 11 emerging payment reform models that reward providers for delivering efficient, quality care or that pay healthcare providers a fixed amount to coordinate treatment.
Eric Schneider, MD, senior scientist and director of RAND Boston, says the study reveals that health plans cannot use any one payment model in isolation and expect to see much result. Rather, Dr. Schneider says, blending the models and working closely with providers to monitor and implement incentives will likely make the most difference for providers and patients.
In this episode of the "Meet the Board" podcast series, Briana Contreras, Managed Healthcare Executive editor, speaks with Ateev Mehrotra, a member of the MHE editorial advisory board and a professor of healthcare policy and medicine at Harvard Medical School. Mehtrotra is also a hospitalist at the Beth Israel Deaconess Medical Center in Boston. In the discussion, Contreras gets to know Mehrotra more on a personal level and picks his brain on some of his research interests including telehealth, alternative payment models and price transparency.
Listen
Inflation Reduction Act: Reforms to Patient Cost-Sharing
September 18th 2023Lower out-of-pocket costs for patients might put upward pressure on drug prices, as manufacturers face less price sensitivity, note Matthew Majewski and Rhett Johnson of Charles River Associates. But they also note that upward pressure on price is likely to be limited to the inflation rate as any additional price increase would need to be paid back to CMS in the form of inflation rebates.
Read More
Spending climbed by 2.7% in 2021. In 2020, it soared by 10.3%, fueled by federal government spending in response to the pandemic. The blizzard of calculations of 2021 healthcare spending by CMS’ actuaries also provides further evidence that utilization of healthcare services bounced back in 2021.
Read More
Talking PIE, the Act, Before Thanksgiving
November 23rd 2022AMCP CEO Susan A. Cantrell spoke with Managed Healthcare Executive® about Preapproval Information Exchange (PIE) Act of 2022, which would allow drug manufacturers to share information about a drug with payers before the drug is approved. Cantrell says passage of the PIE Act would speed up patient access to new medications.
Read More
Inflation Reduction Act and the Impact on Pharmaceutical Pricing and Investment Decisions
November 21st 2022The reference to “maximum fair price” in the act bodes poorly for manufacturers and suggests more of a take-it-or-leave-it situation rather than a negotiation where clinical evidence would be the prevailing factor in determining price.
Read More