With half a year behind us, The American Journal of Managed CareÂ® (AJMCÂ®) is reflecting back on the journal articles published through all journals in the franchise over the first half of 2017. The topics of interest ranged from alternative payment models to yoga and all focused on providing better care and better outcomes for patients.
With half a year behind us, The American Journal of Managed Care® (AJMC®) is reflecting back on the journal articles published through all journals in the franchise over the first half of 2017. The topics of interest ranged from alternative payment models to yoga and all focused on providing better care and better outcomes for patients.
10. Can Yoga, Mindfulness Fit With Managed Care?
This article from Evidence-Based Diabetes ManagementTM (EBDMTM) explored how studies have linked yoga and mindfulness with reduced stress, improved glycemic control, and even lower medical costs, but few health plans pay for yoga and mindfulness. Payment reforms in healthcare may help: the Affordable Care Act’s focus on preventive care and wellness raised yoga’s profile with payers. In addition, President Donald J. Trump and Speaker Paul Ryan (R-Wisconsin)’s support for health savings accounts may allow more people to be able to pay for yoga.
9. Why Oncologists Need Technology to Succeed in Alternative Payment Models
The emergence of alternative payment models is requiring oncologists to develop new solutions to meet the requirements of these programs. However, while people have focused on model design, care delivery reform, financial impact, and quality of care, there has been little discussion on practical aspects of how practices work. In Evidence-Based OncologyTM (EBOTM) authors from Flatiron Health offer their solution to how practices can utilize Flatiron’s electronic health record.
8. The Challenge of Paying for Cost-Effective Cures
The US health system faces a challenge of paying for highly effective and cost-effective prescription drugs. Because they are highly effective, these drugs, based on a value-based system, are very expensive, but the US health system is fragmented, which doesn’t incentivize payers to pay these high prices for cures. Authors in this article from AJMC® suggest mechanisms that can help spread the burden of financing cures across payers.
7. Value-Based Payment Models in Oncology: Will They Help or Hinder Patient Access to New Treatments?
In the April issue of EBOTM, authors from Deloitte highlighted the results from recent interviews of 18 individuals from health plans, provider groups, and clinical pathway developers to better understand what value-based payment models are working to help bring down the cost of treatments. They found that early experiments with value-based payment models show some progress, but there is still room for improvement.
6. Treating Medicaid Patients With Hepatitis C: Clinical and Economic Impact
The high cost of new treatments for hepatitis C means they are often restricted in Medicaid patients. A study in AJMC® estimated the change in chronic hepatitis C and the economic burden associated with comprehensive treatment of patients in Medicaid with chronic hepatitis C. They determined that a “treat all” strategy resulted in a higher cure rate, substantial reductions in downstream negative clinical outcomes, and considerable cost savings.
5. Phase 3 GALLIUM Study Shows Promising Results With Obinutuzumab for Follicular Lymphoma
Results of the phase 3 GALLIUM study were presented at the 58th Annual Meeting & Exposition of the American Society of Hematology that found obinutuzumab-based immunochemotherapy and maintenance among patients with previously untreated follicular lymphoma resulted in a significant improvement in progression-free survival compared with rituximab therapy.
4. A Bundle of Nudges: Healthcare Payment in an Era of Behavioral Science
In an article for EBDMTM, Mike Payne, MBA, MSci, formerly of Virta Health, discusses how digital health can be used to manage chronic disease; however, payment models that recognize this type of care are still evolving. Digital health allows for health and medical services to provide continuous “nudges” to an individual’s behaviors associated with chronic disease, which has been shown to have positive results, such as improving influenza vaccination rates by 30%.
3. CAR-T Cells: The Next Era in Immuno-Oncology
Chimeric antigen receptor (CAR)-T cells are an immunotherapy that has the potential for a huge impact on oncology care. The February issue of EBOTM was dedicated entirely to immuno-oncology, and the authors called CAR-T therapy the next frontier in immuno-oncology. Research into CAR-T has shown incredible results: 90% of patients with relapsed and refractory acute lymphoblastic leukemia experienced complete remission 1 month after receiving a CAR-T infusion, according to the first published trial.
2. Value-Based Contracting Innovated Medicare Advantage Healthcare Delivery and Improved Survival
A study in the February issue of AJMC® tested the hypothesis that payer-provider risk contracting promotes high-value care. Researchers studied how value-based contracting generated cost efficiencies and improved clinical outcomes in Medicare Advantage. The results showed that value-based contracting can drive utilization patterns and improve clinical outcomes among chronically ill, elderly Medicare Advantage members.
1. Impact of a Pharmacy-Based Transitional Care Program on Hospital Readmissions
Researchers evaluated the impact of pharmacist-provided postdischarge services on hospital readmissions. The study analyzed members of a managed Medicaid health plan and found that the community pharmacy-based postdischarge program significantly reduced readmission rates at 30 and 180 days compared with usual discharge care. The pharmacist interventions focused on patient education, resolving medication-related problems, and facilitating access to postdischarge appointments and medications.