Lola Butcher
Patient-reported outcomes measures (PROMs) use a patient’s response to questions to measure health status. If they’re going to catch on payers will need to incentivize use. So far, that’s not happening. But clinicians who use PROMs for clinical decision making might be providing a valuable service.
Joseph Burns
The United States spends more—close to double—on health care per capita than other rich countries. By many measures, we’re not getting a good return on those trillions of dollars.
Medication Management
Thomas Reinke
Next month, the Sanofi and Regeneron product is expected to become the fourth monoclonal antibody approved as a treatment for severe asthma.
News Wire
The experiments that produce “miracle” drugs do not often reflect a diverse population.
Cleared for Adults with Relapsed or Refractory Disease
NDEA, a Known Carcinogen, Discovered During FDA Testing
May Reduce the Need for Open-Heart Surgery
Conversely, Kids Who Need Drugs Go Untreated
News & Commentary
Some heavy-hitting health care organizations think that the prior authorization process needs improvement, saying in a consensus statement that it “can be burdensome for all involved—health care providers, health plans, and patients. Yet, there is wide variation in medical practice and adherence to evidence-based treatment.”
Cover Story
Lola Butcher
The pay-for-value movement could justify rewarding—and punishing—doctors based on quality scores. Problem: Hardly anyone likes the current ways quality is measured, especially physicians. Few believe that Medicare’s Merit-based Incentive Payment System (MIPS) will clear things up. In fact, it might cause more confusion.
Value-Based Tools
Michael D. Dalzell
Three quarters of the original ACOs that remain in the MSSP are still in Track 1. The Trump administration is tired of waiting for them to take on two-sided risk.
CURRENT ISSUE September 2018

Measuring Value and the Role Nurse Practitioners Play in Health Care

It’s a happy accident that this month we take a long look at value and the role nurses and nurse practitioners play in health care. True, our cover story and our Value-Based Tools department discusses value in terms of just how physicians should shoulder down-side risk. Our cover story points out that hardly anyone likes any of the current approaches to measuring value. Value-Based Tools reports that CMS insists that ACOs start taking on two-sided risk.

Enter nurse practitioners. We say: Enter nurse practitioners. Not yet, because as our story on these providers shows, many state laws prevent nurse practitioners from entering fully into primary care. Medical societies insist that they be tethered to doctors’ offices. NPs counter that they’re doing just fine in states that give them full scope of practice. A turf war, in which quality plays a central role.

UPCOMING MEETINGS
Washington, DC
September 27-28, 2018
Washington, DC
September 27-28, 2018
Chicago, IL
October 04-05, 2018
Alexandria, VA
October 10-11, 2018
Philadelphia, PA
October 10-11, 2018
Los Angeles, CA
October 29-30, 2018
Los Angeles, CA
October 29-30, 2018
Viewpoint
Jennifer Bright
Mark Linthicum
The “waste-free formulary” under development by the Pacific Business Group on Health sounds promising, but ultimately may not deliver the impact to self-insured employers its creators are promising. The approach glosses over a critical question: What constitutes “high-value”? The definition of value plays a central role in determining the care that patients ultimately receive.
News & Commentary
Instead of relying on price comparison tools that insurers offer, patients instead will go where their doctors tell them to go to get MRIs, and in the process drive by an average of six other places where the procedure could have been done more cheaply.
Jan Greene
And that means full scope of practice as primary care providers. Medical societies hate the idea and think that nurse practitioners need to be tethered securely to a physician office in order to ensure top-notch care. Nurse practitioners counter that they can help shore up primary care.