Value-Based Care

Larger primary care practices in downside risk–only payment models and capitation saw the highest telemedicine utilization rates by their patients enrolled in Medicare Advantage (MA) plans.

The Medicare Access and CHIP Reauthorization Act (MACRA) needs to be reimagined get back on track and to live up to its promise to incentivize value-based care.

At a session of AHIP 2021 Institute and Expo Online, the head of North Carolina's health and human services department and a health equity policy advisor in the Biden administration discussed how collecting and using data to achieve health equity is ultimately a policy decision.

A report from Xcenda showed that biosimilars for 8 blockbuster reference biologics have successfully kept drug prices from increasing by an average of 56%, restoring the possibility that biosimilars could achieve significant discounts despite facing several barriers to uptake.

One-third of health care in the United States is wasted. Despite this recognition, solutions are sparse. The Optimal Care model combines evidence-based medicine, patient-centered technology, and outcomes reporting to transform health care.

The Medicare Payment Advisory Commission (MedPAC) suggested several changes to Medicare Advantage (MA) plan benchmark calculations, with the intent to generate yield savings for Medicare, and urged CMS to streamline alternative payment model (APMs) where it can.

In a 7 to 2 decision, the Supreme Court ruled Thursday that the Affordable Care Act (ACA) will stand, as plaintiffs seeking to declare the law unconstitutional did not have standing.

This study evaluated cost and utilization attributed to members enrolled in a health care program with no pharmacy co-pay. Health care savings were identified in addition to medication adherence improvements.

Policy makers and health plans seek value-based management of specialty drugs. This study examines real-world factors that favor some approaches over others and their potential impact.

The frequency of low-value care can be reduced by a respectful, data-driven process anchored in nonjudgmental communication and explicit core values.

Although the Center for Medicare and Medicaid Innovation (CMMI) has delayed the start of payment models for kidney care, one dialysis provider says it remains committed to the concept.

The summit will address priority patient inputs for comparative effectiveness research and health technology assessments.

Quantifying the return on investment came up for both those implementing an oncology care pathway (as a potential barrier) as well as for payers still not convinced it is a way to go.

Reducing cascades while maintaining our commitment to high-quality care requires equipping patients and clinicians with the information, tools, and support to embrace uncertainty.

Several barriers continue to impede the transition to value-based payment, particularly administrative and clinical data connectivity, transparency of quality metrics and quality measures, and prioritization of social determinants of health.

A panel of experts provided consumer insights into value-based insurance design (VBID) and how the COVID-19 pandemic may have changed consumer behaviors in a way that VBID may be able to address as the country emerges from the pandemic.

A desire to remove barriers to high-value care and provide services that would improve health and quality of life drove early adopters of value-based insurance design (VBID).

Clinician-, patient-, and research-focused initiatives are needed to reduce the delivery of low-value care services that contribute to financial, clinical, and psychological harm for patients.

A panel of policy experts, including employees of the previous 2 administrations and a former lobbyist for health plans, discusses achievements of value-based insurance design and how to take the concept to the next level.

On this episode of Managed Care Cast, we speak with Sheri Winsper, the senior vice president for quality measurement at the National Quality Forum, to discuss how the forum plans to devise national telehealth quality metrics.

A German-style fair value/pricing committee may be in the works for the United States. However, government payers still have work to do before implementing a value assessment system.

As Medicaid is a federated program between states and the federal government, it has historically been difficult for innovation to spread state to state, hindering any comparison of quality metrics.

During a 2021 AcademyHealth National Health Policy Conference session, members of The Commonwealth Fund Task Force on Payment and Delivery System Reform discussed policy recommendations aimed at preparing the United States for future pandemics and addressing care inequities brought to light by the coronavirus disease 2019 crisis.

To ensure that value assessment accounts for patient needs, we need a better understanding of the outcomes that are most important to patients, write authors from COVIA Health Solutions and the University of Washington School of Pharmacy.

Experts outlined the impact value-based insurance design (VBID) has had on the coronavirus disease 2019 (COVID-19) pandemic response and future potential applications of the model.

Harlan Levine, MD, highlighted the chasm present in oncology today during his talk during this year’s Patient-Centered Oncology Care® 2020 conference.

COVID-19 has created a significant distraction from normal practice operations. The uncertainty that comes along with the pandemic is a huge worry, and can distract from practice transformation.

Value-based insurance design has made gains in oncology, but there's more work to do.

At the Alliance for Better Health’s CONVERGE Virtual Conference, experts discussed the role social determinants of health (SDOH) play in community-based health initiatives.