It is often an on-again, off-again disease, distressing partly because it is so unpredictable. It may defy the conventional wisdom about adherence and early treatment. And escalating prices have undercut cost-effectiveness arguments for the drugs that can keep it in check. Multiple sclerosis is a managed care nightmare.
Pharma is used to risk, but adoption of alternative payment models would mean learning to navigate shared risk with payers.
Here’s a list, by no means exhaustive, of think tanks that have developed conservative and libertarian policies and principles in health care
Care managers can quickly assess clinical complexity and monitor members climbing the cost and risk curve if they are armed with up-to-date information about a member’s medical and behavioral diagnoses, prescription medications, physician office visits, emergency room visits, and hospitalizations.
Companies that negotiate for better prices on specialty drugs without the incentive of discounts and rebates.
ProPublica has identified key personnel in the Trump health policy apparatus.
Use apps to keep patients connected to the health care system during transitions and in between visits.
Deal with people’s isolation and disconnection to head off physical health problems—and possibly health care costs.
Deliver hospital-level care in people’s homes to achieve better outcomes and save money.
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.
Use telehealth to avoid expensive inpatient care and deliver excellent care to even the most remote places.
Pharma and Trump administration officials decry them as backroom deals. But payers and PBMs say rebates are an important negotiating tool with drugmakers. Take it away and drug expenditure will go up even faster.
But the adoption of new technology is rarely smooth; learning curves create jagged edges. The gee-whiz factor of technology can easily get ahead of true utility and effectiveness. And, of course, there’s the expense. Hospitals and other providers need to be ready to plow millions in new machines.
Contractor has challenges to overcome in turning a dead parrot into a phoenix.