Innovation and Role of Alternative Markers of Efficacy - Episode 4

Segment 4 - Healthcare Policy: Its Impact on Innovation and Financial Waste

Ira M. Klein, MD, MBA, FACP, describes how studies examining healthcare spending have found that up to 30% (several billions dollars) is wasteful. Thus, he suggests that there is a need to take a look at the overall healthcare system and assess ways to reduce inefficient spending. He points out that the Center for Medicare and Medicaid Innovation (CMMI) is fostering innovation by supporting pilots on models of clinical care delivery.

Another strategy to curtail unnecessary services, reducing economic waste, is to provide bundled payments for specific conditions, based on predicted expenses. Implementing bundled payments shifts the risk to the provider or care delivery organization—this is the model for the accountable care organizations (ACOs).

Richard W. Joseph, MD, agrees with “the principle of giving some skin in the game to the physician to be the most efficient that he can.” He believes that bundled payments are a good idea, but do have inherent problems that need to be addressed.

Watch our related Peer Exchange, Oncology Stakeholder Summit 2014: Evidence-Based Decisions to Improve Quality and Regulate Costs