François de Brantes, whose payment reform organization merged with the Altarum institute about a year ago, has been fired. His last day was Friday. An email from Altarum’s president and CEO, Lincoln Smith, that circulated at the institute, said he had “tremendous respect” for de Brantes but after…
Colleen McHorney, PhD, Evidera
Jan Greene
Physicians and their charges have different ideas about what makes for good cancer care. Patient surveys help, but they need to be handled right.
The questions: Should CMS increase pay to PCPs for services that they currently provide but are not compensated for, and pay for new services that CMS would like PCPs to perform? Or should CMS pay for demonstration projects that target high-need, high-cost Medicare beneficiaries? CMS’s answer, at least for the time being, is a bit of both.

News Wire

Janssen drug targets metastatic urothelial cancer, marked by poor outcomes
Increased risk of high-frequency hearing loss pegged at 60%
Alexion announces positive top-line results for ALXN1210 in PNH
Risk approaches 13% for women who fall ill early in pregnancy
Interview by Peter Wehrwein
Anthem’s vice president of provider alignment solutions wants providers to know that the spigot of upside-only risk arrangements will not stay open forever.
Charlotte Huff
Elizabeth Eckstrom, MD, Oregon Health & Science University
Research has pointed to ways that falls can be prevented, but logistical and financial barriers get in the way.
Mark Nathan
Once they have the right platforms in place, insurers can layer on predictive analytics, digital medical records, and other innovations that promise to make health care costs more manageable—and in the process make health insurers more competitive with the likes of CVS and maybe, eventually, Amazon.

Value-Based Health Care and Its Disconnects

Value-based health care aims to staunch the excess of volume and intensity of services that fee for service and many employer-sponsored health plans encourage. But it presents as many questions as answers.

Medicare’s jumped in with both feet. Take a look at our in-depth review of BPCI Advanced, a new bundled payment program that’s expected to be popular even though concerns persist about episodes, risk adjustment, and use of quality data.

How about real-world evidence (RWE)? Not quite ready for prime time because of festering credibility problems.

Mai Pham, MD, Anthem’s vice president of provider alignment solutions, takes the bull by the horns in her riveting interview with Editor Peter Wehrwein. She says that physicians need to accept downside risk.

Our issue looks at the potential and these very real concerns surrounding value-based health care. 


Boston, MA
March 26, 2018 to March 27, 2018
Orlando, FL
April 23, 2018 to April 24, 2018
Las Vegas
April 29, 2018 to May 2, 2018
Washington, DC
April 29, 2018 to May 2, 2018
Michael D. Dalzell
Medicare’s new bundled payments program is expected to be popular, despite unanswered questions about the target prices for the episodes, risk adjustment, and use of quality data. Here’s what we know—and don’t know.
Frank Diamond
The 40-year-old has to guide one of the health insurer’s regional markets as the ACA continues to evolve. His course? Keep strengthening ties with providers.
Peter Boland
Mistreated is a comprehensive and brilliant analysis of American health care by Robert Pearl, the CEO of the Kaiser Permanente Medical Group. The book’s subtitle aptly summarizes the author’s point of view: “Why We think We’re Getting Good Treatment–and Why We’re Usually Wrong.”