Value-Based Care

Samyukta Mullangi, MD, MBA, of Tennessee Oncology and Thyme Care, discusses the future of specialty value-based care and how attendees can apply what they learned at the Institute for Value-Based Medicine event on August 22.

National data sets and registries are able to provide outcomes data and process measures that testify to quality of care being delivered, said Matthew Nielsen, MD, FACS, chair, Department of Urology, University of North Carolina School of Medicine.

The authors advocate for a consideration of 2 distinct phases of obesity management (ie, active weight loss and maintenance of weight loss) to allow substantially more people access to antiobesity medications.

The authors advocate for a strategy that reallocates the substantial workforce effort and financial resources currently devoted to low-value care to enhance access and affordability of high-value services.

Low-value service utilization is common among all older adults, and utilization of some high-value services decreases after the onset of cognitive decline.

The findings can help reduce barriers that delay the onset of recommended palliative care in advanced cancer.

Ronesh Sinha, MD, attributes the rising rates of heart disease to sedentary lifestyles, stress, and health inequities, while advocating for digital health solutions to improve preventive care.

A new program from Optum Rx would offer greater predictability by using a guarantee-based pricing model.

Kimberly 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.

In 2024, the Asembia Specialty Pharmacy Summit celebrated 20 years and speakers highlighted the conversations around improving access and affordability taking place at the meeting.

Leaders at 49 accountable care organizations (ACOs) shared their perspectives on the Medicare Shared Savings Program, as well as a range of strategies for success and ongoing challenges.

While the novel payment models for expensive cell and gene therapies have been effective, they need to continue evolving, said Joe DePinto, MBA, of McKesson.

Optum 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.

The 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.

Asembia AXS24, which has record registration this year, will take place in Las Vegas, Nevada, April 28-May 2, at the Wynn & Encore Las Vegas.

On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.

Beau Raymond, MD, MMM, FACP, chief medical officer of Ochsner Health Network, explains the importance of diabetes and hypertension control to prevent downstream events such as heart attacks and strokes.

As provider and payer organizations pursue the Quadruple Aim, it is important that they take into account not just the contracting but also the transformation in staffing, clinical workflows, and culture as these organizations evolve.

Robert Sidbury, MD, MPH, FAAD, division head of dermatology at Seattle Children's Hospital and professor of pediatrics at the University of Washington School of Medicine, discusses implementing value-based care initiatives in a pediatric dermatology practice.

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.

To deliver on the promise of value-based care, organizations need to return to the fundamental objective: to deliver high-quality, affordable care to our communities.

Engaging 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.

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.

It is possible, if you lay the groundwork, to provide patients with acute leukemias with aggressive and effective therapies, while still allowing them to maintain quality of life, explained Jennifer Vaughn, MD, of The Ohio State University Comprehensive Cancer Center – James Cancer Hospital.

After 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.