During the opening segment of this program, part of the Healthcare Reform Stakeholders Summit, Spring 2015 series, moderator Dennis Patrick Scanlon, PhD, asks managed care stakeholders for their insights on the goals of healthcare professionals in value-based purchasing programs and the roles of various stakeholders in these programs.
Ateev Mehrotra, MD, MPH, notes that the transition in our healthcare system from volume-based to value-based will force providers to focus on quality, to achieve improved health at reduced costs.
Two categories of payers actively influence value-based purchasing, comments Francois de Brantes, MS, MBA: employers and consumers, whom he refers to as “the new generation of purchasers.” According to Mr de Brantes, a combination of both employers and consumers as payers is driving the change in payment for healthcare.
Arthur Vercillo, MD, FACS, agrees that consumers are the driving force for value-based purchasing programs, adding that the intent of the Affordable Care Act (ACA) was to provide increased access to healthcare. Dr Vercillo, commenting on value in terms of cost and quality, says he doubts if consumers have always gotten their money’s worth, and that value-based purchasing programs are a step in the right direction.
Medicare is the driving force that everyone else follows, according to Dr Mehrotra. While private payers are innovating and seeking alternate models, he strongly believes that Medicare took the lead in terms of initiating value-based purchasing programs, followed by the introduction of similar programs by private payers.
As the discussion continues, Mr de Brantes explains that employers have been a pioneer in this movement since the 2000s, while private sector payers are operationalizing various models more broadly. Acknowledging that private sector payers have gained from the groundwork laid by the ACA and the Center for Medicare & Medicaid Innovation, Mr de Brantes proposes that consideration should be given to what the private sector could and should be doing to drive these efforts forward.
HOPE-CAT Can Identify Maternal Cardiovascular Risk 2 Months Earlier Than Doctors, Study Says
April 25th 2024In a retrospective study, the machine learning tool was able to screen for potential risks of cardiovascular disease nearly 60 days before the patient's medical record showed any signs of a related condition or before they were officially diagnosed or treated for it.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen
Polatuzumab Vedotin and R-CHP Appropriate for Untreated DLBCL
April 24th 2024Population pharmacokinetic and exposure-response analyses revealed a favorable benefit-risk profilane for the treatment combination of polatuzumab vedotin and rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP).
Read More