Health technology assessment (HTA) is a tool that helps to objectively evaluate evidence, which levels the playing field for new therapies looking to demonstrate cost-effectiveness, according to Steve Pearson, MD, MSc, president of the Institute for Clinical and Economic Review. In doing so, stakeholders can better understand the balance between innovation and affordability.
Value frameworks are tools used to clarify cost-benefit tradeoffs in healthcare decisions, which means they can look very different depending on their intended audience, according to Clifford Goodman, PhD, moderator at the ACO Coalition spring live meeting in Scottsdale, Arizona, and senior vice president and director at the Center for Comparative Effectiveness Research at the Lewin Group.
In the 180-plus years Daughters of Charity has been in New Orleans, the health system has implemented a number of innovative ideas, from air-conditioned hospitals to community health networks, according to Michael Griffin, president and CEO. The future is looking even brighter as more patients become insured and gain access to care, he added.
Andrew Rhinehart, MD, chief medical officer at Glytec, discusses the transition from intermediate outcomes in diabetes research of glycemic results to harder outcomes that will benefit the patient financially and through their care.
CareMore is beginning to form innovative partnerships with companies like Lyft, while also strengthening its internal ability to provide more outreach, according to Sachin H. Jain, MD, MBA, president and CEO. Jain said that CareMore’s prepaid model allows it to fully manage every dollar it receives.
Patient engagement offers opportunities for shared decision making between visits, when those with diabetes or obesity make choices about food, exercise, or medication that affect health outcomes.
Legislators and Congress need to be pressured to achieve more price transparency in order to manage the high costs on insulin says Alan Carter, PharmD, principal investigator and senior advisor at MRIGlobal, and adjunct faculty at University of Missouri—Kansas City School of Pharmacy.
Both political parties want to lower the price of drugs, but differ in how they think it should be done. Gail Wilensky, PhD, of Project HOPE, explained her opinion that spurring more competition would be a more successful approach than directly implementing price controls.
Data breaches and cyberattacks can have costly and damaging consequences for healthcare organizations, but there are some steps that can be taken to mitigate the risk and impact of these incidents, explained Lee Barrett, executive director of the Electronic Healthcare Network Accreditation Commission.
Ideally, researchers determining the clinical and economic effects of a new treatment would have both short-term and long-term data, explained Steve Pearson, MD, MSc, president of the Institute for Clinical and Economic Review. If not all of this data is available, however, they may have to use surrogate outcomes or perform indirect comparisons.
The Community Oncology Alliance (COA) is forging ahead with its COA Patient Advocacy Network (CPAN), says Rose Gerber, director of patient advocacy for COA. The network’s major focuses include increasing its presence and making it easier for community practices to get involved.
According to Eda Cengiz, MD, MHS, FAAP, associate professor of pediatrics at Yale School of Medicine, diabetes management technology is just beginning and can have a positive impact on the daily lives of diabetes patients.
By aligning payers to care about population health and social determinants of health, it will help improve the health of the community as a whole, said Michael Griffin, president and CEO of Daughters of Charity Services.
Though no country has a drug pricing system that would work perfectly in the United States, there are many components that could potentially be adapted for use here, like strengthened price negotiation abilities, said Clifford Goodman, PhD, moderator at the ACO Coalition spring live meeting in Scottsdale, Arizona, and senior vice president and director at the Center for Comparative Effectiveness Research at the Lewin Group.
Prescribers and pharmacies can encounter some unique challenges when specialty drugs are e-prescribed, but organizations like the National Council for Prescription Drug Programs are trying to make the process smoother, explained Laura Topor, president of Granada Health.
Informed consent is one of the principal values in healthcare, but it should include discussions about cost, said Jacqueline Glover, PhD, professor in the Department of Pediatrics and the Center for Bioethics and Humanities at the University of Colorado Denver. Glover also discussed the need to clarify the language surrounding end-of-life care.
The Trump administration’s healthcare priorities have mainly focused on replacing the Affordable Care Act or reforming Medicaid, leading to concerns that value-based purchasing efforts will be left in the dust, said David M. Cutler, PhD, of Harvard University.
CareMore has launched an integrated delivery model that provides primary care to patients while at the dentist’s office, with the idea of maximizing the value of each encounter with the healthcare system, explained Sachin H. Jain, MD, MBA, president and CEO.
As more practices adopt the COME HOME model, they are adapting it to fit their needs, explained Barbara McAneny, MD, chief medical officer of New Mexico Oncology Hematology Consultants. However, some practices may not have the resources to keep up with data collection requirements while ramping up clinical interventions.
Nina Brown-Ashford, MPH, CHES, deputy group director at the CMS Innovation Center, discusses how Medicare’s Diabetes Prevention Program will help improve population health and contain the high costs of diabetes care.
Value-based care strategies will continue to progress no matter who occupies the White House, according to Gail Wilensky, PhD, of Project HOPE. HHS Secretary Tom Price has indicated his support for limited demonstrations, but Wilensky predicts he will continue to push against large-scale mandatory demonstrations.
As practices adopt the Oncology Care Model, practices should consider how this change will influence the practice and make efforts to continue engaging with the staff during this process, said Basit Chaudhry, MD, PhD, founder of Tuple Health.
Material suppliers, manufacturers, pharmacies, and rebate programs all contribute to the rising prices of insulin, according to Alan Carter, PharmD, principal investigator and senior advisor at MRIGlobal, and adjunct faculty at University of Missouri—Kansas City School of Pharmacy.
According to Steve Pearson, MD, MSc, president of the Institute for Clinical and Economic Review (ICER), patient perspectives are critical for determining meaningful outcomes and helping to guide the cost-effectiveness review process.
According to its CEO and president Michael Griffin, Daughters of Charity is undertaking a number of projects that use technology to improve care coordination and communication.
Differential pricing structures are necessary for products with surrogate endpoints and to account for revolutionizing treatments in order to have a more sustainable value equation, according to Scott Ramsey, MD, PhD, of Fred Hutchinson Cancer Research Center.
As a cancer survivor, Rose Gerber, director of patient advocacy for the Community Oncology Alliance, is personally aware of the many long-term issues that can arise during survivorship. These can include physical effects like bone health and emotional issues like the fear of recurrence.
The shift to value-based payment models necessitates greater exchange of data and analytics, including the use of personal health information (PHI), said Lee Barrett, executive director of the Electronic Healthcare Network Accreditation Commission. This heightened amount of data being transferred makes it essential for organizations to have procedures in place that mitigate the risk of data breaches or attacks.
Diabetes patients will be more satisfied with treatment when they perceive benefits and will continue treatment when physicians keep in contact and point out the progress, says William Polonsky, PhD, CDE, president of the Behavioral Diabetes Institute and associate clinical professor at University of California, San Diego.
Real-time prescription benefit transactions are designed to give clinicians essential information on an individual patient’s benefits before writing a prescription, according to Laura Topor, president of Granada Health.