The authors of Understanding Value-Based Healthcare provide this rationale for their book in terms of how to go about improving health care: “Government cannot do it. Payers cannot do it. Regulators cannot do it. Only the people who give care can improve it.”
Partnerships between hospital systems and retailers offer telehealth kiosks. Hospitals hope to find loyal patients, and the retailers see a chance to boost sales.
Community Servings, a not-for-profit organization in the Boston area, delivers medically tailored meals that take into account the nutritional needs of people with chronic illnesses. The idea is to ensure that a patient’s food addresses his or her specific health conditions.
Price transparency, payment reform, and consumerism are needed to bring market forces to health care. Too many managed care organizations are comfortable with the status quo.
Quality clinical practice for the management of diabetic patients should include screening for nephropathy. Reliance on a prescription alone should not be considered evidence of effective screening for such patients when that drug is used for other clinical indications.
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.
Despite standardization, advocates for various industries and certain patient needs continue to propose changes in coverage rules. Much of the advocacy is occurring at the state level with a focus on pharmaceutical coverage, such as equalizing cost sharing between oral and infused oncology drugs or setting limits on cost sharing for prescriptions.
Next month, the Sanofi and Regeneron product is expected to become the fourth monoclonal antibody approved as a treatment for severe asthma.
Pharma is used to risk, but adoption of alternative payment models would mean learning to navigate shared risk with payers.
Current asthma guidelines combine treatment, follow-up, and re-evaluation to manage asthma control, reduce impairment, and decrease risk of morbidity in patients. Analysis reveals that FeNO monitoring to guide asthma management is cost effective, increasing quality-adjusted life years while decreasing costs associated with asthma management.
Geisinger’s goal is to be not just one of the top health care organizations, but one of top organizations among all the companies in the United States.
The FDA’s work to redefine ‘truthful and non-misleading’ communication may preempt state efforts.
Deliver hospital-level care in people’s homes to achieve better outcomes and save money.
Use telehealth to avoid expensive inpatient care and deliver excellent care to even the most remote places.