Vertical integration may make sense in the era of value-based care. But will the combinations limit patient choice–and pass antitrust muster?
They can work, but pharma will need to master the intricacies of adherence metrics, real-world outcomes, and sampling.
The caveats: About 40,000 Americans are newly infected every year. And HIV infection is still among the top 10 leading causes of death among Americans between the ages of 25 and 44.
The caveats: It is difficult to study. The strongest evidence is for palliative care in hospitals.
Public opposition would be unseemly, so insurers and hospitals work behind the scenes against price transparency.
Community health workers liaise between underserved populations and clinicians, help patients and resources to manage disease, and provide health education, informal counseling, and social support. Interest in community health workers is shifting away from narrowly focused intervention on a single disease toward care coordination of multiple chronic conditions.
The caveat: Joint replacements might be a sweet spot for bundled payments. They might not work as well for other episodes of care.
A nurse-focused program at Virginia Mason Medical Center in Seattle travels upstream to treat and prevent delirium, one of the main causes of falls in the hospital. The program was associated with a near halving of the delirium-related fall rate.
The caveats: Most of the evidence involves routine care. It is uncertain whether nurse practitioners will be willing to work in rural areas to fill the primary care void.
The check marks in this table show current health-reform bills cosponsored by 15 key senators.
The caveats: They may need to be part of larger programs to be effective. And smoking rates have fallen but remain stubbornly high among people without privilege.
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.”