Articles

Administrator Seema Verma said the proposal would create opportunities "for drug manufacturers to have skin in the game through payment arrangements that challenge them to put their money where their mouth is."

CMS Issues Rules to Promote Value-Based Contracting, Pay for High-Cost Therapies in Medicaid

Could the COVID-19 Pandemic Create New Opportunities for the Adoption of APMs and Be a Catalyst for the Movement From Volume to Value?

When deciding which treatments to cover, states and commercial payers must wrestle with opportunity costs as new therapeutics come to market. A panel at Virtual ISPOR 2020 discussed some of the factors that go into those decisions.

Linking Opportunity Costs and Value Assessments for State and Commercial Payers

Two of the panelists appearing during the Virtual ISPOR 2020 meeting preview what's needed in improving value assessment: Lou Garrison, PhD, of the University of Washington, and Leah Howard, JD, of the National Psoriasis Foundation.

Virtual ISPOR Panel to Examine Next Steps in Value Assessment

Accountable care organizations (ACOs) have saved Medicare a total of $3.53 billion from 2013 to 2017, or $755 million after shared savings were paid out, according to a new report from the National Association of ACOs (NAACOS).

NAACOS: ACOs Saved Medicare $3.5 Billion From 2013 to 2017

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.

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

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.

HHS Releases Proposal to Reform Stark Law, Antikickback Rules

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.

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

Podcasts

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. 

Dissecting OCM Performance Period 4 Results and Their Implications

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.

IVBM News