Value-Based Medicine News
CMS Issues Rules to Promote Value-Based Contracting, Pay for High-Cost Therapies in Medicaid
June 18th 2020Administrator 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."
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Linking Opportunity Costs and Value Assessments for State and Commercial Payers
May 20th 2020When 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.
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Virtual ISPOR Panel to Examine Next Steps in Value Assessment
May 18th 2020Two 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.
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NAACOS: ACOs Saved Medicare $3.5 Billion From 2013 to 2017
December 4th 2019Accountable 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).
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Value Considerations Should Begin Very Early in the New Drug Development Life Cycle
October 31st 2019Value 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.
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HHS Releases Proposal to Reform Stark Law, Antikickback Rules
October 9th 2019In 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.
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Defining, Standardizing, and Acting on Patient-Reported Outcomes in Cancer Care
September 27th 2019During 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.
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Dissecting OCM Performance Period 4 Results and Their Implications
September 25th 2019With 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.
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Examining Physician-Initiated Alternative Payment Models, a New Wave of Payment Reform
September 12th 2019To 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.
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How Are Oncology Practices Communicating Value-Based Care to Employers and Patients?
August 14th 2019On 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.
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KOL Corner: Amy Ellis Discusses Viewing Value-Based Care as a Culture With Jeff Hunnicutt
August 8th 2019Transitioning 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.
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V-BID X: A Template for Aligning Cost Sharing With Value of Services
July 30th 2019The 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.
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Addressing the Complexities of Value-Based Payment Models
July 24th 2019As value-based models continue to change the payment landscape in healthcare, the models require more sophisticated data, analytics, and payment structures, which can lead to more administrative burden, as well as siloed data.
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