- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Innovative Payment and Delivery Models: Are They Working?
There are a lot of new payment and delivery models available and being tested, but the US still doesn’t have a payment system that aligns people’s incentives the right way, said Margaret E. O’Kane. Instead, with fee-for-service around, people still have an incentive for overuse, because they can make money.
Watching the new payment and delivery models, though, she pointed out that it’s important to not just get caught up on whether a certain model work. That’s not the right mindset. Instead, people should choose a model and make it work by adjusting it until payment policies are in place to reward efficiency.
Matt Salo added that while it’s great to consider shared savings or bundled payments, they need to be paired with the right tools to make them work. He used the example that primary care physicians need to be shown how to set up a patient-centered medical home, how to structure it, who to hire, etc.
He tied the conversation into patient engagement in new delivery models and figuring out what motivates the patient and why, for instance, are families overusing the emergency room.
“You’ve got to figure out why are they doing what they’re doing that’s wrong, and how do you empower them to do the right thing,” Salo said.
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
American Advocacy and Action for Minority Health in 2025
April 4th 2025Accessing equitable health care is an ongoing struggle in the US for minority communities due to historical pretexts with new setbacks surfacing as recent administrative changes emerge, highlighting the urgent need for continued advocacy during National Minority Health Month.
Read More
Radiation Bridging Therapy Boosts CAR T Outcomes in R/R LBCL
April 3rd 2025In this comparative analysis, patients with relapsed/refractory large B-cell lymphoma (R/R LBCL) received bridging therapy via radiation or systemic treatment while their chimeric antigen receptor T-cell therapy (CAR T) was being manufactured.
Read More
