Reimbursement Multimedia Compendium

Reimbursement Compendium


Michael Kolodziej, MD, describes value benchmarks for the immunotherapeutic agents, how adverse events and side effects fit into a total cost model, and how to ensure that physicians do not undertreat due to budget constraints.
Michael Kolodziej, MD, discusses the impact of FDA approval on the selection, use, and insurance coverage of therapies; the rationale for investing in new agents; and how surrogate endpoints affect coverage decisions.
Payment reform's impact on socioeconomic disparities may not matter if the growth in healthcare expenditures in the United States means the government or payers can’t afford to pay for the medicines, said Andrew L. Pecora, MD, FACP, CPE, chief innovation officer professor and vice president of cancer services at the John Theurer Cancer Center.
Performance measurement is at the heart of improving healthcare, and part of this transition to value-based payment means creating measures that track the improvements of quality care, said Marcia Wilson, PhD, MBA, senior vice president of quality measurement at The National Quality Forum.
Rocco Perla, president of Health Leads, explained that not only do stakeholders in the health system need to come together, but that the conversation also must be patient-centered to truly make headway in care reform.
Stephen Nuckolls, CEO of Coastal Carolina Quality Care, explained during his presentation at the National Association of Accountable Care Organizations Spring 2016 Conference that the more physicians read and learn about value-based care, the more they are accepting the change. He added that as the idea has become more accepted, ACOs are beginning to evolve as well.
The future of Accountable Care Organizations is very much undefined, as an ACO right now isn’t working to its full potential. However, Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American, is positive that the healthcare system will get there in the coming years.
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