My take on American Patients First

In broad strokes, the American Patients First plan aims to lower list prices, lower patients’ out-of-pocket costs while maintaining incentives for innovation.   In short, this is a sensible strategy, although there are some concerns about how more restrictive formulary designs could restrict consumer choice. American Patients First in brief To maintain manufacturers incentives to innovate,…

Patient-Centered Formularies: Steps In The Right Direction, But Challenges Remain

That is the title of my latest blog post in Health Affairs with co-author Mark Linthicum.  The premise is as follows: CVS recently announced its new Transform Rheumatoid Arthritis Care initiative, which aims to reshape coverage of rheumatoid arthritis care through “value-based management strategies including outcomes based contracts and a new indication-based formulary for autoimmune…

Outcomes-based pricing for Cardiovascular Disease

An interest Health Affairs blog post on outcomes-based pricing from Daniel M. Blumenthal Samuel Nussbaum Neil J. Weissman and Mark Linthicum. Insurers are increasingly tying health service payments to clinical outcomes to improve care value and quality. Outcomes-based pricing—setting treatment reimbursements to reflect their prospectively determined value to patients and the health care system—is a promising alternative payment…

What is more for cancer patients: increased screening or treatment innovation?

Let’s get this out of the way: both are clearly important.  Within appropriate screening, patients don’t get the treatment they need.  Further, delayed screening can make treatments less effective if the cancer has progressed or metastasized.  On the other hand, without effective treatment, screening won’t have a major impact on patient outcomes. The question is,…