- Center on Health Equity and Access
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- Value-Based Care
Transitioning to Value-Based Reimbursement
The shift from fee-for-service healthcare to a value-based healthcare model has been associated with some challenges, notes Patrick White.
Mr White explains that the main challenge for healthcare groups is in the initial move. He notes that physicians and professionals who had previously been reimbursed under the fee-for-service model have financial concerns related to the switch to value-based reimbursement.
Mr White adds that another challenge is convincing the C-suite to incorporate physicians into the hospital management team. He notes that if presented with the responsibility and authority to make changes, physicians can help improve the overall delivery of care.
Despite these challenges, Mr White explains that the transition to a value-based healthcare model is necessary, and says that certain insurance companies have already begun measuring quality and cost per capita.
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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Real-World Data Show Leqvio's Effectiveness in Reducing LDL-C in Patients With ASCVD
April 11th 2024Results from the V-INITIATE trial showed a substantial 60% reduction in low-density lipoprotein cholesterol (LDL-C) from baseline to day 330 in the inclisiran first group compared with a mere 7% reduction in the usual care group.
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