Value Considerations Should Begin Very Early in the New Drug Development Life Cycle

October 31, 2019


Value needs to be considered early in the development life cycle of a therapy and should be continued throughout, even into the postlaunch space using real-world studies, according to a presentation on value-based services and their life cycles at the AMCP Nexus 2019 meeting.

HHS Releases Proposal to Reform Stark Law, Antikickback Rules

October 09, 2019


In a long-awaited move, HHS announced Tuesday plans to reform federal antikickback statutes and overhaul the so-called Stark Law, which was originally intended as a safeguard against financial incentives that would inappropriately influence physicians’ clinical decisions, in an effort to speed the transition to value-based care.

Defining, Standardizing, and Acting on Patient-Reported Outcomes in Cancer Care

September 27, 2019


During a panel discussion on defining, standardizing, and reporting quality in cancer care during the National Comprehensive Cancer Network Policy Summit held September 12 in Washington, DC, it became clear that stakeholders of all backgrounds have set their focus on one type of metric in particular: patient-reported outcomes.

Dissecting OCM Performance Period 4 Results and Their Implications

September 25, 2019


With Oncology Care Model performance period 4 results out now, it’s a transformative point in the model in which practices that have not yet achieved a performance-based payment have to either enter 2-sided risk or leave the model. To dive into the most recent results and their implications, we spoke with Charles Saunders, MD, chief executive officer of Integra Connect.

Examining Physician-Initiated Alternative Payment Models, a New Wave of Payment Reform

September 12, 2019


To date, most alternative payment models (APMs) that have emerged in the shift toward value-based care have been initiated by payers and focused on primary care providers. However, there has recently been a new wave of payment reform in which providers, mostly specialists, are designing and implementing their own APMs in their practices. A study published in the September issue of The American Journal of Managed Care® analyzed some of these new payment models to gain insight into what providers are prioritizing in their APMs.

The Adoption and Spread of Hospital Care Coordination Activities Under Value-Based Programs

August 14, 2019


Value-based programs such as accountable care organizations appear to encourage the adoption and spread of care coordination activities by hospitals.

How Are Oncology Practices Communicating Value-Based Care to Employers and Patients?

August 14, 2019


On this episode of Managed Care Cast, we’re bringing you a portion of a panel discussion about the Oncology Care Model, held in July 2019 during a meeting of The Institute for Value-Based Medicine® (IVBM), an initiative of The American Journal of Managed Care®. At IVBM events, we gather thought leaders to share best practices across medicine, pharmacy, and management in regional locations around the country. This podcast is taken from our meeting focusing on Innovation and Quality in Oncology Care.

KOL Corner: Amy Ellis Discusses Viewing Value-Based Care as a Culture With Jeff Hunnicutt

August 08, 2019


Transitioning to value-based care is a marathon, not a race, and should be viewed as a mission and a culture, Jeff Hunnicutt, chief executive officer at Highlands Oncology Group, told Amy Ellis, director of quality and value-based care at Northwest Medical Specialties. In order to successfully transform a practice, there needs to be a clear message and set values ingrained in the mindset of staff at the frontline of patient care.

V-BID X: A Template for Aligning Cost Sharing With Value of Services

July 30, 2019


The University of Michigan Center for Value-Based Insurance Design (V-BID), in collaboration with a group of healthcare stakeholders, has announced the details of V-BID X, a template for reducing cost sharing for certain high-value services and raising cost sharing for certain low-value services while not increasing premiums or deductibles.

Inspector General of HHS Praises Strategies Used by ACOs to Shift to Value-Based Care

July 26, 2019


A new report from the HHS’ Office of the Inspector General praises 20 high-performing accountable care organizations (ACOs) for the strategies they are using in the shift to value-based care.