March 20th 2024
For 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.
Dr Mark Fendrick Explains Implementation of VBID in Commercial Markets
October 17th 2022Most implementations of value-based insurance design (VBID) in commercial markets involve prescription drugs, but some plans are beginning to incorporate cost-sharing offsets, said A. Mark Fendrick, MD, co–editor in chief of The American Journal of Managed Care® and director of the Center for Value-Based Insurance Design at the University of Michigan.
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Growing Innovation, Cost Expected in the Oncology Drug Pipeline
October 15th 2022The concluding keynote address at the Academy of Managed Care Pharmacy Nexus 2022 meeting discussed new and emerging oncology drugs in the pipeline and their potential impact on the treatment landscape as it pertains to managed care providers.
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Anne Marie Rainey on Always Putting Patients First and How Technology Can Help
October 14th 2022Patients have to always come first, and technology can enhance their care experience, stated Anne Marie F. Rainey, MSN, RN, CHC, director of quality and value-based care at Clearview Cancer Institute.
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Drs David and Scott Penberthy Are Working to Evolve Cancer Care in the 21st Century
October 14th 2022On day 1 of this year’s Association of Community Cancer Centers’ (ACCC) National Oncology Conference, The American Journal of Managed Care® sat down for a conversation with David Penberthy, MD, MBA, ACCC’s president for the 2022-2023 term, and his brother Scott Penberthy, PhD, MS, director, Applied AI, Office of the CTO, at Google.
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Allina Health’s Mike Koroscik Addresses Oncology Innovations Rooted in the COVID-19 Pandemic
October 14th 2022There have been many silver linings of the pandemic, including improvements in financial, operational, and clinical advancement efficiencies, as well as addressing the total cost of care in population health management, said Mike Koroscik, MBA, MHA, vice president of oncology, Allina Health and the Allina Health Cancer Institute.
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Dr Mark Fendrick Outlines IRA Provisions Targeting Prescription Drug Costs
October 14th 2022The Inflation Reduction Act (IRA) contains provisions allowing Medicare to negotiate net prices for prescription drugs, but it remains to be seen whether this will translate into savings for beneficiaries, explained A. Mark Fendrick, MD, co–editor in chief of The American Journal of Managed Care® and director of the V-BID Center at the University of Michigan.
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Google’s Dr Scott Penberthy on How AI Is Helping to Facilitate More Time With Patients
October 13th 2022Much of artificial intelligence (AI) is now being used in the more mundane areas of health care, figuring out where to be most helpful, so doctors can do what they do best, which is diagnostic care, noted Scott Penberthy, PhD, MS, director, Applied AI, Office of the CTO, at Google.
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AMCP Nexus 2022 to Address Evolving Value-Based Frameworks, Shared Decision-Making
October 10th 2022The annual fall meeting of AMCP Nexus 2022 will feature a keynote from one of the top physician-executives in health care, the specialty pharmaceutical pipeline, and insights for managed care stakeholders in selecting and integrating cost-effective, value-based care frameworks.
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Dr Mark Fendrick Suggests Additional VBID Elements to Be Adopted in Health Policy
October 9th 2022Congress should build on the value-based insurance design (VBID) elements included in the Inflation Reduction Act to further alleviate the burden of health care costs on Americans, said A. Mark Fendrick, MD, co–editor in chief of The American Journal of Managed Care® and director of the V-BID Center at the University of Michigan.
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There Needs to Be an Arbiter of High-Quality, High-Value Cancer Care, Says Dr Lucy Langer
October 6th 2022With multiple pathways and stakeholders involved, there needs to be an arbiter who decides what is the highest quality and highest value care in oncology, said Lucy Langer, MD, MSHS, national medical director, oncology and genomics, UnitedHealthcare.
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Dr Mark Fendrick Highlights VBID Elements in the Inflation Reduction Act
October 5th 2022Elements inspired by the principles of value-based insurance design (VBID) were incorporated into the recently signed Inflation Reduction Act, which could help reduce costs of care for patients, according to A. Mark Fendrick, MD, co–editor in chief of The American Journal of Managed Care® and director of the V-BID Center at the University of Michigan.
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Dr Stephen Schleicher: Culture, People, Analytics Contributed to OCM Success
October 2nd 2022Co-hosted by Memorial Sloan Kettering Cancer Center, the most recent Institute for Value-Based Medicine® event took place on September 22, with a focus on improving cancer care delivery through innovation.
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Potential for PHC Necessitates Pediatric Cardiology Care for Children With PAH
September 28th 2022Outcomes following right heart catheterization in a pediatric patient population were analyzed, with emphasis placed on risk of adverse outcomes following the procedure, especially the development of pulmonary hypertensive crisis (PHC).
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Contributor: Improving Utilization Management Can Better Outcomes, Cut Costs in Cardiovascular Care
September 18th 2022Russell Rotondo, MD, FACC, medical director of clinical strategy and innovation for cardiology at Cohere Health, discusses the myriad positive ways utilization management programs can have an impact on patient outcomes in cardiovascular care.
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Horizon Model Makes Behavioral Health the "Quarterback" in Chronic Care Management
July 20th 2022Stakeholders from Horizon Blue Cross Blue Shield of New Jersey discuss new ways to address management gaps for chronic behavioral health conditions, including a new integrated care model that puts community behavioral health providers in charge of overall care.
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Integrated Primary Care Effective for Patients With Severe COPD With No Increase in Costs
July 19th 2022An integrated primary care service may improve the health status of patients with severe chronic obstructive pulmonary disease (COPD) without increasing health care costs, according to a recent study.
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Evaluating Value-Based Contracting in Behavioral Health: A Q&A With Vanessa Bobb, MD, PhD, FAPA
July 5th 2022At AHIP 2022, Vanessa Bobb, MD, PhD, FAPA, vice president of Behavioral Health & Medical Integration at CDPHP, moderated a session on real-world study findings showcasing cost and quality benefits of value-based contracting in behavioral health. Bobb discusses findings of the study and how value-based programs can be better leveraged in mental health and substance abuse care.
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FCS’ Walcker Outlines His Hopes for Successor Model to OCM
July 1st 2022In the second of 2 parts, Nathan H. Walcker, MBA, CEO of Florida Cancer Specialists & Research Institute (FCS), discusses what he’d like value-based care to look like going forward. CMS ended the Oncology Care Model (OCM) yesterday after 6 years and has invited practices to apply for a successor model, the Enhancing Oncology Model.
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FCS’ Walcker Explains Value-Based Cancer Care
June 30th 2022In the first of 2 parts, Nathan H. Walcker, MBA, CEO of Florida Cancer Specialists & Research Institute (FCS), discusses the future of value-based care for the practice as the Oncology Care Model comes to an end today. This week, CMS announced it will launch a successor model.
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Dr Ravi Parikh Offers Solutions to Barriers During Shift From Fee-for-Service to APMs
June 10th 2022Designing rational spending targets and having small sample sizes are 2 main challenges payers and partners face in the shift toward alternative payment models (APMs), said Ravi B. Parikh, MD, MPP, assistant professor of medical ethics and health policy, assistant professor of medicine, University of Pennsylvania.
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Ashok Subramanian on Considerations for Employers Designing Value-Based Care Frameworks
June 8th 2022Ashok Subramanian, MBA, founder and chief executive officer, Centivo, speaks on the limitations of traditional employer-based health benefit plans in the pursuit of value-based care and what employers should consider in designing these incentives on a community level.
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