Crisis Into Opportunity: Can COVID-19 Help Set a Path to Improved Health Care Efficiency?
With a “new normal” level of care going forward post coronavirus disease 2019 (COVID-19), the key will be to invest in high-value services while deterring a resurgence of low-value care.
Outcome Measures for Oncology Alternative Payment Models: Practical Considerations and Recommendations
This review presents a set of evidence-based outcome measures for oncology alternative payment models, drawing on evidence from existing and proposed quality measures.
Variation in US Private Health Plans’ Coverage of Orphan Drugs
Health plans restrict orphan drug coverage less often than nonorphan drug coverage. However, the frequency of restrictions varies considerably across plans.
Understanding and Improving Value Frameworks With Real-World Patient Outcomes
New value frameworks should incorporate real-world evidence that reflects patient treatment behavior, adherence to medication, and equity concerns arising from disparities in care.
Mapping US Commercial Payers' Coverage Policies for Medical Interventions
The authors examine the largest 20 US commercial payers’ coverage policies and identify variation in how interventions are covered and the evidence reviewed in them.
The Impact of Formulary Drug Exclusion Policies on Patients and Healthcare Costs
The authors review empirical evaluations of drug exclusion policies to examine their impact on patients and on healthcare costs.
Private Sector Risk-Sharing Agreements in the United States: Trends, Barriers, and Prospects
Assessment of current trends, success factors, and challenges in the use of risk-sharing agreements in the US private sector.
Multiple Chronic Conditions in Type 2 Diabetes Mellitus: Prevalence and Consequences
This study's findings showed that diabetes care remained suboptimal among many patients with multiple chronic conditions and that patient outcomes varied by multimorbidity profile.
The Value of Specialty Pharmaceuticals - A Systematic Review
This study examines whether patients treated with specialty pharmaceuticals have improved outcomes compared with patients treated with conventional therapies, and evaluates costs associated with these treatments.
Low-Value Services in Value-Based Insurance Design
Building negative incentives into value-based insurance design programs to discourage use of low-value care will involve a number of challenges.
Patient Adherence: A Blind Spot in Cost-Effectiveness Analyses?
A systematic literature review from 1998 to 2003 showed that few cost-effectiveness analyses of self-administered medications model suboptimal medication adherence.
A Strategic Plan for Integrating Cost-effectiveness Analysis Into the US Healthcare System
A panel composed of medical and pharmacy directors expressed strong support for a greater role for cost-effectiveness analysis in US health policy decisions.
Quality of Clinical and Economic Evidence in Dossier Formulary Submissions
Do Drug Formulary Policies Reflect Evidence of Value?
The Impact of Medicare Modernization on Coverage Policy: Recommendations for Reform
Why Don’t Americans Use Cost-Effectiveness Analysis?
Barriers to Using Cost-Effectiveness Analysis in Managed Cae Decision Making
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