Value-Based Care

Panelists touted the ability to pay for items and repairs to keep Medicare beneficiaries healthier at home, avoiding potentially costly hospitalizations and complications.

Without addressing rising costs, the problem of underinsurance in health care coverage will remain, said panelists at the 2022 V-BID Summit, discussing some of the smaller steps that are being proposed or are already in place to try to ease the financial burden.

At the 2022 V-BID Summit, hosted by the Center for Value-Based Insurance Design at the University of Michigan, representatives of CMS and the Commonwealth Fund gave an update on the efforts to monitor, evaluate, and improve health equity in the United States.

Dennis P. Scanlon, PhD, professor of health policy and administration at Pennsylvania State University and editor-in-chief of The American Journal of Accountable Care®, talks about major systemic and fundamental barriers to health systems becoming learning health systems.

Patients who cardiologists see once every few months are getting handed over to pharmacists who can monitor them more frequently and get them to their goals, said Crystal Zhou, PharmD, assistant professor of Clinical Pharmacy at the University of California, San Francisco (UCSF).

Angela Storseth-Cooper, associate director, Government Relations & Public Policy, The US Oncology Network, discusses state-level legislation that community oncology practices can leverage to address issues involving pharmacy benefit managers and the vertical integration of health plans and specialty pharmacies.

Lalan Wilfong, MD, vice president of Payer Relations & Practice Transformation at The US Oncology Network, speaks on how use of health economics and outcomes research has benefitted patient care in the community oncology setting and where it can be further leveraged in the pursuit of value-based care.

The redesigned accountable care organization (ACO) model is called the Realizing Equity, Access, and Community Health model and is scheduled to begin in 2023.

Speaking during a webinar presented by the National Alliance of Healthcare Purchaser Coalitions, experts weighed the pros and cons of employer high-deductible health plans (HDHPs) and outlined steps to address challenges raised.

Dennis P. Scanlon, PhD, professor of health policy and administration at Pennsylvania State University and editor-in-chief of The American Journal of Accountable Care, discusses his 2021 end-of-year letter calling on health system leaders to learn and innovate in real time.

Kenneth Cohen, MD, FACP, executive director of clinical research at UnitedHealth Group Research and Development and senior national medical director at OptumCare, discusses areas where low-value care is more prevalent and the shift to high-value care.

Kenneth Cohen, MD, FACP, executive director of clinical research at UnitedHealth Group Research and Development and senior national medical director at OptumCare, discusses evidence-based education and other tools to address low-value care.

Part 1 of a 2-part webinar series by the National Alliance of Healthcare Purchaser Coalitions addressed issues in health care coverage affordability and how equitable health benefits and value-based design can reduce cost while improving employee engagement.

In its annual Medicare Shared Savings Program (MSSP) report, CMS said the number of accountable care organizations joining increased, but a trade group said the results should have been better.

Kimberly Westrich, MA, vice president of health services research at the National Pharmaceutical Council, discusses opportunities for growth regarding value-based benefits.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 5.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 2.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 1.

The most-read AJAC papers of 2021 analyze real-world programs to transform health care and provide insight into physician perspectives of health care and insurance.

Kimberly Westrich, MA, vice president of health services research at the National Pharmaceutical Council, discusses value-based benefit design strategies for high-deductible health plans.

Kimberly Westrich, MA, vice president of health services research at the National Pharmaceutical Council, speaks on common misconceptions when designing value-based benefits.

Kimberly Westrich, MA, vice president of health services research at the National Pharmaceutical Council, discusses the shift to a value-based system from a fee-for-service one and how the health care system can incentivize high-value care.

The announcement of a "strategic refresh" for payment models under the Center for Medicare and Medicaid Innovation offered no details on what practices should expect when the Oncology Care Model (OCM) expires in 2022.

Michael E. Chernew, PhD, co-editor-in-chief of The American Journal of Managed Care®, discussed cost and sustainability issues specific to commercial insurance, Medicare, and Medicaid at the National Alliance 2021 Annual Forum held in a hybrid format in Washington, DC.

On this episode of Managed Care Cast, we speak with Abi Sundaramoorthy, MD, MBA, executive vice president of clinical enterprise at Somatus, on fragmented care in chronic kidney disease, its disproportionate impact on minority communities, and the potential of value-based arrangements to address disparities and promote preventive, effective care.

A panel at Asembia 2021 Specialty Pharmacy Summit in Las Vegas addressed challenges in the treatment journey of patients with rare diseases, efforts to improve access to gene therapies, and cost and value considerations for stakeholders.

The state of value-based contracting in specialty pharmacy was addressed in a panel discussion at Asembia 2021 Specialty Pharmacy Summit in Las Vegas, with speakers touching on the essentials of such agreements, how to optimally integrate them, and future considerations for the pharmaceutical marketplace.

Some policy reforms can help incentivize more use of value-based contracts, but overall an area that needs more work is value-based contracts with pharmaceutical companies, said Steven Peskin, MD, executive director, director of population health, Horizon Blue Cross Blue Shield of New Jersey.

Horizon Blue Cross Blue Shield of New Jersey has been involved in a number of value-based cancer care initiatives that will be highlighted during an upcoming Asembia session, said Steven Peskin, MD, MBA, executive director, director of population health, Horizon Blue Cross Blue Shield of New Jersey.

This study demonstrates the need for additional consensus surrounding how to translate guideline recommendations to administrative measures assessing imaging overuse for acute low back pain.