Dr Michael Kolodziej: Insurers May Never Use Value Frameworks

With value frameworks still in their infancy, Michael Kolodziej, MD, national medical director for oncology strategy at Aetna, doesn't see how his company can use them just yet. In fact, these frameworks may never be used by insurers, but only for shared decision making between the patient and provider.

With value frameworks still in their infancy, Michael Kolodziej, MD, national medical director for oncology strategy at Aetna, doesn't see how his company can use them just yet. In fact, these frameworks may never be used by insurers, but only for shared decision making between the patient and provider.

Transcript (slightly modified)

Does Aetna plan to leverage the value calculators and frameworks that are no available?

At the present time no. And I think part of that is because they are all works in progress. Now, I will say, and I have said this multiple times, I applaud everybody who is working in this space around their courage, in attempting to objectively define a way of measuring value: having worked in the clinical pathways space for a long time, that was basically the same thing. The better thing now is that people seem to have caught the virus of being interested in quantifying value, but there are some important things missing that make it really, really hard for me to totally embrace them.

The 2 most important things that are missing are the element of real-world evidence—and I think we need to support efforts to collect real-world evidence—and second of all, the patient voice is not adequately represented. I think those are solvable problems and as we look to the next set of iterations we will see attempts to incorporate them. But speaking from the insurance company point of view, I don't see a way that the insurance company is going to use them. But I do see a way that they are going to become an important component of shared decision making at the physician-patient level.