Latest Conference Articles

Value-based insurance design (VBID) aligns patient cost sharing with the value of clinical services, so that patients pay less for high-value services and more for unnecessary, low-value services. While there has been increased interest in VBID, with CMS expanding the VBID demonstration in Medicare Advantage to all 50 states, the situation on the state exchanges is different: The plan has to be cost neutral, so in order to remove cost sharing for high-value services, cost sharing has to increase for other, low-value services.

The INFINITY trial, presented at the 68th Scientific Session of the American College of Cardiology, tracked hypertension, brain lesions, and gait in groups of older seniors who had their systolic blood pressure managed to either 130 mm Hg or 145 mm Hg. Results showed significant differences in brain lesions between the 2 groups after 3 years.

New results presented at the American College of Cardiology's 68th Annual Scientific Session find a high-dose fish oil pill reduced the risk for first and future cardiovascular events among patients taking statins by 30%. The early results grabbed headlines last fall in part because researchers aren't entirely sure how the capsule works.

While the high price of drugs is an issue, what is really important is the actual cost patients are faced with at the pharmacy counter, said Ted Okon, executive director of the Community Oncology Alliance, and Daniel Klein, president and executive director of the Patient Access Network Foundation, at the University of Michigan Center for Value-Based Insurance Design (V-BID), V-BID Summit.

In recent years, the big news on the first day of the American College of Cardiology (ACC) Scientific Session and Exposition has involved a therapy—usually an expensive cholesterol drug with a name almost no one could pronounce: proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. This year, it's tech, and an easy-to-pronounce name: Apple.

The concept of value is a well-known topic among health policy experts, the payer community, and policy makers, but patients do not necessarily have the same idea of what value means. When discussions about removing low-value care from the system to save money come up, patients might get the wrong idea of what is going on and why.

There has always been interest in bundled payments, and now the industry is moving toward implementing more, explained Scott Hewitt, vice president, payment strategy and innovation, UnitedHealthcare.

There is a lot involved if an accountable care organization (ACO) decides to switch from Medicare Shared Savings (MSSP) to Medicare Advantage, but Medicare Advantage offers more benefit design flexibility, explained Kim Kauffman, MPH, vice president of value-based care at Summit Medical Group.

Some children treated with egg oral immunotherapy (OIT) are likely to continue eating and tolerating egg 5 years after treatment, according to research that may someday lead to the development of biomarkers to predict who will respond to OIT. The research was presented at the 2019 Annual Meeting of the American Academy of Allergy, Asthma & Immunology.

Two abstracts presented Saturday at The American Academy of Allergy, Asthma & Immunology 2019 Annual Meeting, held February 22-25 in San Francisco, California, discussed how formulary switching can affect outcomes for patients with severe persistent asthma, as well as how improving outcomes may be associated with increased quality measures.

Even when there are treatment failures, the knowledge gained through food allergy studies helps to move the field forward, explained Robert A. Wood, MD, director, Pediatric Allergy and Immunology, Johns Hopkins Medicine; 2018-2019 president, American Academy of Allergy, Asthma, and Immunology (AAAAI).

The Institute for Accountable Care has a massive database to understand which accountable care organizations (ACOs) are successful and why, as well as how best to implement accountable care programs, explained Rob Mechanic, MBA, senior fellow at the Heller School of Social Policy and Management at Brandeis University and executive director of the Institute for Accountable Care.

As CMS prepares to implement its new Pathways to Success program (formerly Medicare Shared Savings Program) for accountable care organizations (ACOs), some ACOs may consider Medicare Advantage a more beneficial arrangement, explained Kim Kauffman, MPH, vice president of value-based care at Summit Medical Group.

Three months following the 2018 midterm elections, a panel discussion at AcademyHealth National Health Policy Conference, held February 4-5 in Washington, DC, outlined how much healthcare did, or didn’t, play a role in the elections, as well as what healthcare trends to expect in 2019.

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