Elizabeth Eckstrom, MD, Oregon Health & Science University
Charlotte Huff
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.
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.

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
More drugs or more costly drugs are being prescribed, industry trade group says
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.”
Frank Diamond
When it comes to heart attacks, additional health care spending was only weakly associated with lower case-fatality rates, according to a study of Medicare patients. What did make a difference to researchers was coronary angioplasty on the first day of heart attack patients’ hospitalizations.

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. 


Philadelphia, PA
March 19, 2018 to March 21, 2018
Orlando, FL
March 19, 2018 to March 20, 2018
Philadelphia, PA
March 19, 2018 to March 21, 2018
Philadelphia, PA
March 19, 2018 to March 21, 2018
Philadelphia, PA
March 19, 2018 to March 21, 2018
Boston, MA
March 26, 2018 to March 27, 2018
Orlando, FL
April 23, 2018 to April 24, 2018
Douglas C. A. Taylor, MBA
Jessica L. Abel, MPH
As expected, pharmacy costs increased with the introduction of this new treatment in a market dominated by over-the-counter and generic treatments. On the other hand, outpatient GI-related and irritable bowel disease health care resource use and costs substantially decreased among commercial and Medicare patients following linaclotide treatment initiation.
Women’s Health
Jan Greene
This old standby’s ultimate demise will likely take place when cervical cancer incidence declines as the HPV vaccine starts to take effect at a population level. New guidelines are being written, but insurers could have a major influence on how closely those guidelines are followed. So far, though, they haven’t waded very far into the Pap-HPV debate.
Peter Boland
Ezekiel J. Emanuel’s Prescription for the Future is true to its title and proposes a five- to 10-year agenda for transforming expensive, wasteful American health care into a system that delivers high-value care. This is a qualitative book based on case studies that identify and systematize how to improve quality, patient experience, and cost.