The transition to value-based care has been helpful in getting providers to examine their own performance and find ways to improve quality, said Andrei Gonzales, director of value-based reimbursement initiatives at McKesson Health Solutions.
The transition to value-based care has been helpful in getting providers to examine their own performance and find ways to improve quality, said Andrei Gonzales, director of value-based reimbursement initiatives at McKesson Health Solutions.
Transcript (slightly modified)
Where have you seen some of the most impressive innovation happening in healthcare?
I’d say plans like Horizon BlueCross BlueShield in New Jersey have shown a lot of promise with how their bundled payment model, patient centered medical home. We’ve seen some of their adoption increasing over the last few years, and just recently they’ve started to show some real improvements in terms of outcomes and also control and costs.
Models like the state of Arizona and the bundled payment program they have there have really shown that providers, when they see that their costs or their complications are out of sorts with their peers, and they look at benchmarks, they’ve really made an effort to improve that. And that’s what it really comes down to is that as practitioners, you know, practitioners really want to provide the best possible care to their patients.
But in a fee-for-service world, it’s sometimes difficult to really understand what types of care and outcomes they’re achieving; whereas in some of these value-based models they really look at care as an episode of care, which is how we experience it as patients, and they start to see, okay, I’m really not providing the best care, or I really could make some improvements in cost that would make a real difference to the patients I care about. And that transparency and that information really helps to drive some of the transition.
Navigating Sport-Related Neurospine Injuries, Surgery, and Managed Care
February 25th 2025On this episode of Managed Care Cast, we speak with Arthur L. Jenkins III, MD, FACS, CEO of Jenkins NeuroSpine, to explore the intersection of advanced surgical care for sport-related neurospine injuries and managed care systems.
Listen
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
Listen
How Mirdametinib Improves QOL for People With NF1-Associated Plexiform Neurofibromas
March 18th 2025Christopher L. Moertel, MD, University of Minnesota, discusses the trial data that helped get mirdametinib approved and what providers can do to keep measuring quality of life (QOL) improvements.
Read More
For Neuromuscular Disease Community, an Era of Opportunities and Threats
March 17th 2025Robert Califf, MD, former commissioner of the FDA, delivered a keynote address at the 2025 Muscular Dystrophy Association Clinical & Scientific Conference that highlighted the enormous opportunities for progress in neuromuscular disease care amid a changing policy environment.
Read More