CMS continues to push on measuring and reporting information from the consumer perspective for Medicare Advantage and Part D contracts. Others will follow, and we can expect more emphasis on member-reported outcomes and experience measures across all lines of business.
Britain’s National Health Service is taking a good look at how Americans do ACOs. But the move toward accountable care in England has already gotten mired in disputes (and confusion) about what organizational form it should take and whether current proposals are legal.
Think of this alternative payment model as a large set of event-driven care packages that get triggered by consumer–patients. Each care package can be priced and adjusted for the individual’s medical history. Providers who want to bid for the care package can, and what they’re offering will be available and comparable to other providers.
Nathan White, Mike Pace, Adam Johns, and Eric Latch
A few years ago, if you had mentioned ICER, even pharma industry insiders wouldn’t know what you were talking about—or would have confused it with confirmation of naval orders (aye, sir!). Now ICER—the acronym for the Institute for Clinical and Economic Review—has become familiar to anyone involved…
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.