Reducing Low-Value Care Is Hard, but What About Just Not Paying for It?
March 14th 2024After years of efforts to reduce low-value care, panelists at the 2024 Value-Based Insurance Design Summit proposed a new strategy: drawing a line in the sand that payers will not be on the hook for these services.
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Evolution of HDHPs With VBID Components Can Improve Care for Chronic Disease
March 14th 2024Over the course of the last 20 years, high-deductible health plans (HDHPs) have undergone an evolution. Today’s plans, with more high-value services covered predeductible, can improve care for people with chronic diseases, said panelists at the 2024 Value-Based Insurance Design (V-BID) Summit.
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Fragmented Payer System, Vulnerable Supply Chain Among Threats to Accessing Essential Medicines
March 13th 2024During a session of the 2024 V-BID Summit, panelists Stacie Dusetzina, PhD, and Inma Hernandez, PharmD, PhD, discussed how access to essential medications is curtailed not just by the longstanding complexities of insurance design but also by emerging threats such as supply chain weaknesses and cyberattacks.
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Inappropriate Wrist MRI: Did Guidelines Have an Impact?
This article analyzes the use of MRI in a national sample of patients with wrist pain before and after consensus guideline publication.
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Primary Care Delivery Is in Urgent Need of Innovation
February 28th 2024At an Institute for Value-Based Medicine® event cohosted by The American Journal of Managed Care® and Optum, speakers emphasized that innovation is urgently needed in primary care delivery to address the broken US health care system.
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What We’re Reading: ACA Enrollment Increase; Adult ADHD Surge; High Rent Health Effects
January 11th 2024Health insurance enrollment through the Affordable Care Act (ACA) insurance marketplace has broken a record for the third consecutive year; attention-deficit/hyperactivity disorder (ADHD) treatment prescriptions for adults surged during the COVID-19 pandemic, contributing to lingering shortages; paying high rent can shorten your lifespan.
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Top 5 Content From Institute for Value-Based Medicine® Events in 2023
December 27th 2023In 2023, there were 18 oncology and 7 population health Institute for Value-Based Medicine® events cohosted with organizations such as Optum, OneOncology, Vanderbilt Ingram Cancer Center, Duke Health, Cleveland Clinic, and Memorial Sloan Kettering Cancer Center.
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Humana Report Shows Benefits of Value-Based Care for Patients, Physicians
December 6th 2023Patients seen at value-based care clinics received more preventive screenings and had lower risks of hospitalization and emergency room visits, according to Humana’s 10th annual value-based care report.
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Overcoming Challenges to Value-Based Care Implementation: Grant Andres
November 10th 2023In an interview with The American Journal of Managed Care®, Grant Andres, BSc, DC, BSN, MSN-RN, senior director of clinical operations at Arizona Oncology, discussed the nuances of successfully implementing value-based care initiatives across a large organization.
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How Can Oncology Clinical Pathways Contribute to Burnout? Dr Lucy Langer Explains
November 8th 2023There is a lot of noise in the health care system, and oncologists need to collaborate and decide on common shared goals, said Lucy Langer, MD, MSHS, national medical director of oncology and genomics at UnitedHealthcare.
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Dr Samyukta Mullangi on Leveraging Technology Intelligently in Oncology Care
November 8th 2023Leveraging technology intelligently can make the patient-doctor interaction much more seamless and connected, said Samyukta Mullangi, MD, MBA, medical director of oncology at Thyme Care, medical oncologist at Tennessee Oncology.
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EOM Shows Awareness of Issues, but Provides No Resources, Says COA’s Nicolas Ferreyros
November 4th 2023The Enhancing Oncology Model is trying to address a number of the systemic challenges oncology faces without giving practices the tools and resources they need, said Nicolas Ferreyros, managing director of policy, advocacy, and communications, Community Oncology Alliance.
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Dr Sophia Humphreys Highlights Important Topics of Newport Beach IVBM
November 3rd 2023Sophia Humphreys, PharmD, MHA, BCBBS, discusses highlights of the Institute for Value-Based Medicine® (IVBM) event, held in partnership with Providence Health System, that recently took place in Newport Beach, California.
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Allina Health’s Mike Koroscik on Revolutionizing Early Cancer Detection Through Technology
October 26th 2023Through the integration of a population health reimbursement model in 2020, Allina Health Cancer Institute was able to implement expanded screening initiatives through the use of artificial intelligence and precision medicine, according to Mike Koroscik, MBA, MHA, vice president of oncology, Allina Health.
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Dr Melissa Levine on Implementing Value-Based Care in the Primary Care Setting
October 26th 2023Melissa Levine, MD, a family medicine specialist at Arizona Community Physicians and medical director for the Abacus Health accountable care organization (ACO), discussed strategies for succeeding in an ACO and how primary care can complement oncology care for patients with cancer.
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Dr Lalan Wilfong: Patients Deserve the Full Benefit of Everything We Can Provide
October 23rd 2023At the 2023 COA Payer Exchange Summit being held October 23-24 in Reston, Virginia, Lalan Wilfong, MD, US Oncology Network, emphasizes the importance of oncology care equity, ensuring continuity of care, and enhancing care coordination.
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This analysis demonstrates value and innovation of direct-acting antivirals for the treatment of chronic hepatitis C in the US Kaiser Permanente health system.
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Dr Kristine Slam: In Breast Cancer, Patient Values and Treatment Goals May Differ
October 16th 2023Kristine Slam, MD, FACP, Central Ohio Surgical Associates, addresses the importance of involving patients in decisions regarding their goals for treatment, emphasizing that this involvement is critical to uncover what they value, as well as their short- and long-term goals for treatment.
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Dr Alma Habib: Effort Needs to Be Put Into Addressing Disparities in Leukemia, Lymphoma Care
October 15th 2023Alma Habib, MD, The Ohio State University Comprehensive Cancer Center, talks about the fact that disparities are able to be recognized in leukemia/lymphoma care, but the questions of how to address these disparities remain.
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Dr Sarah Wall: Putting Attention on Older Adults With Blood-Based Cancer Is Vital Moving Forward
October 10th 2023Sarah Wall, MD, talks about how it’s important to consider patient age when treating older patients with cancer because it will impact so many of them and blood cancers act differently and can be more aggressive in older adults.
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