Unbiased Analysis of Today's Healthcare Issues
That was the title of the second plenary at ISPOR Europe this year. One interesting slide from Nancy Devlin who outlined how different countries used different patient-reported outcome measures (PROMs). English NHS PROMs programme. Variation in provider performance linked to reimbursement UK Private Healthcare Information Network (PHIN). Part of an initiative to improve patient choice…
That is the connection made between Medicare Advantage (MA) Star Ratings under the Quality Bonus Program (QBP) and Garrison Keillor well-known segment on the Prairie Home Companion in a recent paper by Teno and Ankuda (2022). To better understand this linkage, first recall the famous quote from Mr. Keillor: That’s the news from Lake Wobegon,…
This is according to a recent Viewpoint in JAMA from Binger, Chen and Harder (2022). On July 26, 2022, US News & World Report published new and updated health equity measures for hospitals featured on the publication’s website… Each equity measure was developed under a framework comprising 3 domains: access, outcomes, and social determinants of…
The Oncology Care Model (OCM) is dead. The Oncology Care Model was a voluntary, alternative payment model (APM), that “included financial and performance accountability for episodes of care surrounding chemotherapy administration to cancer patients.” OCM expired at the end of June 2022, and will be replaced by the Enhancing Oncology Model. EOM is a also…
How do efficiently is care provided for patients at Veteran Affairs’ hospitals as compared to private hospitals? This is not an easy question to answer as the composition of patients differs between these hospitals. Even among dually-eligible individuals–those with both VA and commercial insurance–individuals treated at VA hospitals are generally more severely ill. To better…
Patients want new treatments to improve their quality of life. However, do typical patient reported outcomes adequately capture new treatment’s impact on factors that patients care most about? A paper by Perfetto et al. (2022) argues that the answer is ‘no’. The article notes that not only do patients want improved functional status, but also…
That is the topic of a new paper by Drummond et al. (2022). When medical devices receive regulatory approval, payers can make one of three coverage decisions: (1) approve, (2) reject or (3) coverage with evidence development (CED). Note that all countries approve medical devices based on safety and efficacy but only England, the Netherlands,…
What disease components are most burdensome to patients? How do researchers find this information out? To answer this question, the Food and Drug Administration (FDA) recently put out its second guidance document on Patient-Focused Drug Development: Methods to Identify What Is Important to Patients. A few qualitative approaches they recommend to collect this information include:…
Alternative payment models (APM) are the new trend of the past few decades. High quality, efficient providers should be paid more; low-quality, less efficient providers should be paid less. These APM reimbursement arrangements, however, are typically paid at the health system level and it is unclear whether these incentives trickle down to individual physicians. A…
An interesting article in Modern Healthcare reviews some discussion at a recent Medicare Payment Advisory Commission (MedPAC) meeting. The first issue is that the pool of fee-for-service Medicare beneficiaries is shrinking, at least on a relative basis. As Medicare Advantage grows each year, population-based alternative payment models like accountable care organizations are left with a…