The cystic fibrosis medication is plenty expensive, and the benefit for many patients may end up being pretty modest. A review by FDA staffers noted that Orkambi only offered a small improvement in lung function and did not compare as favorably when it came to decreasing hospitalizations or infections.
It’s value = quality + outcomes ÷ cost. CMS leads the charge, with dozens of programs and pilot projects that involve valued-based care. UnitedHealthcare boasts that $36 billion of the company’s spend last year involved some kind of value-based arrangement. Anthem is in the same ballpark. Seems like a growing trend.
Yes, it failed to uproot the volume and intensity incentives of fee-for service medicine. But P4P deserves credit for getting the world ready for today’s value-based payment by pointing out the absurdity of paying for all services irrespective of their outcomes.
Paying for care by the episodes may be the shortest path to value-based care. But administration is tricky, and early results raise questions about the savings achieved.
Of all the “value-based” provider payment methodologies, this one’s the classic. And it may be mounting a comeback.
Without shared risk, shared savings might not be strong enough medicine for what ails American health care.
Ruling in same-sex marriage case extends insurance coverage, but problems with discrimination and lack of access persist.
David Balto, formerly FTC
One of the purposes of health care reform was to create more competition, and the recent spate of acquisitions works against that.
Elliott Antman, MD
This knowledge won’t come cheap, as the system braces for new agents that could add another $42 billion to the nation’s drug bill.
The combination of a neprilysin inhibitor and an ARB rescued neprilysin inhibition from obscurity.