Value-Based Care

As the US charts its course through the next political era, it is crucial that we boldly allocate resources and prioritize what truly impacts patients. When faced with complexity, feasibility concerns, or entrenched norms, we must proclaim: “It’s the outcomes, stupid.”

The policy community should consider these concrete suggestions to address the challenges presented by social determinants of health.

As health care moves toward a value-based payment model, the pharmacy benefit is going in the opposite direction, one that places unit cost over clinical appropriateness.

This is the third article in a series on value-based care and the 4 challenges health care organizations must overcome.

Payers and providers face challenges surrounding data integration, patient engagement, and financial pressures when trying to improve care quality and reduce costs.

Viet Le, PA-C, Intermountain Health, gives insights into the benefits cardio-renal-metabolic care models provide for patients in need.

Navdeep Tangri, MD, PhD, FRCP, University of Manitoba, speaks to the value of population health strategies in clinical approaches to care delivery for patients with chronic kidney disease (CKD).

Lalan Wilfong, MD, a 20-year medical oncologist with Texas Oncology, is senior vice president, value-based care, Thyme Care.

In this interview from our Institute for Value-Based Medicine® event in Boston, we speak with Michael Hassett, MD, MPH, Dana-Farber Cancer Institute, on the clinical significance and cost implications of HER2 in the breast cancer space.

This article explores the congruence between payer patient assignment and quality performance and the implications for incentive payments in alternative payment models.

The legacy of redlining continues to harm minority health, with Black individuals facing higher rates of health issues, linked to environmental factors and limited access to resources in regions previously redlined.

Experts discuss how health care organizations can address the "missing patient" problem in our health system.

The 2024 Trends Shaping the Health Economy report gave a past, present, and future look at diabetes care in the US and the role of obesity in these trends.

The National Association of Accountable Care Organizations (NAACOS) September 2024 report outlined data integration, high-value culture, team-based clinical interventions, and more to enhance value-based care.

Linda Bosserman, MD, PhD, FASCO, FACP, of City of Hope, emphasizes the need for a sustainable health care system that balances cost with care so patients can achieve the best survival and quality of life after a cancer diagnosis.

Andrew Leitner, MD, City of Hope, highlights the essential role of supportive care in improving the quality of life of patients with cancer undergoing treatment.

Domestic and international financial challenges in maternity care highlight the need for payment reforms to reduce out-of-pocket costs and better protect pregnant women from financial strain.

The author discusses a program to prevent kidney decline and progression to dialysis by offering education, support services, and help navigating the health care system to those most at risk.

A statement about the acquisition promises that Navigating Cancer will operate independently with no differences in service regardless of a practice's status with a management service organization.

Joseph Alvarnas, MD, of City of Hope, recaps yesterday's Institute for Value-Based Medicine® (IVBM) event on value-based oncology care, emphasizing patient-centered approaches and how attendees can apply these insights in their daily practice.

The authors examine how insurer and patient out-of-pocket payments for advanced prostate cancer differ by drug and health plan type and describe the relationship between these payments and utilization.

The Inflation Reduction Act was signed into law on August 16, 2022, and the debate over its Medicare-related benefits and impact on the prescription drug market has been raging ever since.

With the advances in cancer care, focus has mostly been on lamenting the high cost of these innovations instead of making patients and populations healthier, said A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design at the University of Michigan.

As the pharmacist’s role has evolved in the last decade, they’ve become an important part of reducing costs and better managing patients, explained Scott Soefje, PharmD, MBA, BCOP, FCCP, FHOPA, assistant professor, Mayo Clinic College of Medicines and Science.

Steve Pickette, PharmD, BCPS, explains that artificial intelligence (AI)–driven formulary analysis can significantly enhance the efficiency and accuracy of drug selection processes by rapidly compiling and analyzing evidence.

Advances in technology have made active surveillance in men with prostate cancer possible and prevented treatment for men who don’t need it, said Matthew Nielsen, MD, FACS, chair, Department of Urology, University of North Carolina School of Medicine.

Patients on specialty medications may face many barriers that prevent them from getting on or staying on therapy, but a specialty pharmacy integrated into a health system can help address these issues, explained Ryan Nix, PharmD, MMHC, of Vanderbilt Specialty Pharmacy.