This Week in Managed Care: February 13, 2016

Hello, I’m Justin Gallagher, associate publisher of The American Journal of Managed Care. Welcome to This Week in Managed Care, from the Managed Markets News Network.

President Obama's Final Budget

This week, healthcare and basic research were high priorities in the 2017 budget that President Obama sent to Congress. While the budget overall did not get a warm reception, some individual items were well-received last year and may fare well when talks get underway.

Budget priorities include:

• 1 billion dollars for the Cancer MoonShot, designed to speed research for a cure
• $33.1 billion for grants at the National Institutes of Health, including the BRAIN and Precision Medicine initiatives.
• Tax credits to promote research and technology investment.
• $500 million to improve access to mental health care.
• A mandatory 2-year funding increase to expand treatment for heroin and prescription drug addiction and to increase state-level efforts to curb abuse

Clinical Nuance

This week, AJMC’s co-editor-in-chief Dr. Mark Fendrick testified before a Michigan senate subcommittee about the benefits and importance of clinical nuance. Dr Fendrick, who is the director of the Center for Value-Based Insurance Design at the University of Michigan, discussed how these concepts can improve the health of the state’s citizens. Value-based insurance design calls for limiting out-of-pocket costs for patients for those therapies and procedures that bring the greatest clinical value and will save money in the long run. Learn more about the role of clinical nuance in healthcare.

Payers Make Value-Based Payment Deals

As we saw this week, payers are embracing value-based concepts in reimbursement. Both Aetna and Cigna made deals with Novartis to tie reimbursement for a new heart drug, Entresto, based on how well it works for patients.

Aetna’s agreement calls for linking payments to the drug’s ability to match its performance from clinical trials, where it reduced the rate of cardiovascular death related to heart failure.

Texting Program in Diabetes Care

A study published this week in Diabetes Care could be good news for payers seeking a scalable way to get better results from the diabetes prevention program.

Researchers from the University of Colorado added a daily text message to encourage program participants as they tried to follow better diet and exercise regimens. After a year, 17% more of the patients who received the text message achieved at least weight loss of at least three percent, and the results were even better among Spanish speaking participants. Read the story.

Strides in Immuno-Oncology

This month, the current issue of Evidence-Based Oncology revisits the ground-breaking strides in immuno-oncology, from the perspective of providers who have treatment options that were once unthinkable, to payers and patients who face life-saving options along with out-of-pocket costs that could bankrupt many families.

To understand the choices and opportunities in immuno-oncology today, read our new issue.

For all of us at the Managed Markets News Network, I’m Justin Gallagher. Thanks for joining us.