Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
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Forging a Patient-Centric Path to Revolutionize and Redefine Value-Based Care
April 30th 2024Optum Life Sciences and Takeda Pharmaceuticals are partnering on an innovative virtual care pilot program for inflammatory bowel disease meant to both continue the mission of the current value-based health care landscape and raise the bar for personalized care delivery optimization.
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USPSTF Lowers Age for Biennial Mammograms to 40, Citing Early Detection Benefit
April 30th 2024The USPSTF lowered the recommended starting age for mammograms from 50 to 40 years, citing moderate benefits for early detection in this age group. Disparities persist, especially for Black women, highlighting the need for improved access to health care and social support.
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Trends in Low-Value Cancer Care During the COVID-19 Pandemic
Among adults with newly diagnosed cancer, rates of low-value cancer services persisted throughout the COVID-19 pandemic in areas ranging from peridiagnosis imaging to end-of-life care.
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Accountable Care Organization Initiatives to Improve the Cost and Outcomes of Specialty Care
April 2nd 2024Engaging specialty physicians is an emerging area of focus for Medicare accountable care organizations. Enhanced data on specialist costs and outcomes are essential to addressing alignment challenges.
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Covered Preventive Services at Risk: V-BID Summit Breaks Down the Braidwood v Becerra Case
March 20th 2024For more than a decade, certain high-value preventive care services have been covered at no cost to patients under the Affordable Care Act, but a current legal challenge has the coverage at risk.
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Reducing Low-Value Care Is Hard, but What About Just Not Paying for It?
March 14th 2024After years of efforts to reduce low-value care, panelists at the 2024 Value-Based Insurance Design Summit proposed a new strategy: drawing a line in the sand that payers will not be on the hook for these services.
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Evolution of HDHPs With VBID Components Can Improve Care for Chronic Disease
March 14th 2024Over the course of the last 20 years, high-deductible health plans (HDHPs) have undergone an evolution. Today’s plans, with more high-value services covered predeductible, can improve care for people with chronic diseases, said panelists at the 2024 Value-Based Insurance Design (V-BID) Summit.
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Fragmented Payer System, Vulnerable Supply Chain Among Threats to Accessing Essential Medicines
March 13th 2024During a session of the 2024 V-BID Summit, panelists Stacie Dusetzina, PhD, and Inma Hernandez, PharmD, PhD, discussed how access to essential medications is curtailed not just by the longstanding complexities of insurance design but also by emerging threats such as supply chain weaknesses and cyberattacks.
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Inappropriate Wrist MRI: Did Guidelines Have an Impact?
This article analyzes the use of MRI in a national sample of patients with wrist pain before and after consensus guideline publication.
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Primary Care Delivery Is in Urgent Need of Innovation
February 28th 2024At an Institute for Value-Based Medicine® event cohosted by The American Journal of Managed Care® and Optum, speakers emphasized that innovation is urgently needed in primary care delivery to address the broken US health care system.
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What We’re Reading: ACA Enrollment Increase; Adult ADHD Surge; High Rent Health Effects
January 11th 2024Health insurance enrollment through the Affordable Care Act (ACA) insurance marketplace has broken a record for the third consecutive year; attention-deficit/hyperactivity disorder (ADHD) treatment prescriptions for adults surged during the COVID-19 pandemic, contributing to lingering shortages; paying high rent can shorten your lifespan.
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Dr Lalan Wilfong Highlights the Challenges of EOM Compared With OCM
December 28th 2023While the Enhancing Oncology Model is the successor of the Oncology Care Model, it includes some very real challenges for participating practices, explained Lalan Wilfong, MD, senior vice president of payer and care transformation at The US Oncology Network.
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Top 5 Content From Institute for Value-Based Medicine® Events in 2023
December 27th 2023In 2023, there were 18 oncology and 7 population health Institute for Value-Based Medicine® events cohosted with organizations such as Optum, OneOncology, Vanderbilt Ingram Cancer Center, Duke Health, Cleveland Clinic, and Memorial Sloan Kettering Cancer Center.
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Humana Report Shows Benefits of Value-Based Care for Patients, Physicians
December 6th 2023Patients seen at value-based care clinics received more preventive screenings and had lower risks of hospitalization and emergency room visits, according to Humana’s 10th annual value-based care report.
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Overcoming Challenges to Value-Based Care Implementation: Grant Andres
November 10th 2023In an interview with The American Journal of Managed Care®, Grant Andres, BSc, DC, BSN, MSN-RN, senior director of clinical operations at Arizona Oncology, discussed the nuances of successfully implementing value-based care initiatives across a large organization.
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Dr Amitkumar Mehta: CAR T-Cell and Bispecific Therapy Are Complementary, Not Competitors
November 9th 2023Amitkumar Mehta, MD, MBA, University of Alabama at Birmingham, notes the long-term data and potential curative effects of chimeric antigen receptor (CAR) T-cell therapy, while expressing optimism about bispecific therapy with ongoing evolution and the chance of significant patient responses.
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