Posted on January 13, 2022

A Look Back and Ahead

As we enter a new year and the pandemic continues to challenge us individually and collectively, the need for innovations cannot be overstated. At NEHI, we continue to work to advance innovations that address unmet needs and improve health with an increased focus on three priority areas.

Equitable Access to Innovation

Gaps in health equity have become more obvious and pronounced during the pandemic. Higher hospitalization and mortality rates have been plainly associated with race and ethnicity. Our virtual Vaccine Summit series convened experts from health care providers and payers, vaccine development and distribution organizations, and the public health community to provide actionable recommendations to overcome vaccine hesitancy and structure fact-based, trustworthy communications. Later in the year, we were fortunate to engage with Eli Lilly, one of our members, to sponsor a Health Equity Summit. More than 300 corporate and community representatives from across the country joined this virtual event to define collaborations that advance equitable health care in three key areas: digital health, data, and health care access. Following the summit, NEHI and Lilly collaborated to produce a report, Equity in Health and Health Care: A Roadmap to Collaborative Action. The roadmap identifies priorities and specific solutions for organizations to implement in each focus area. We are now planning a roundtable discussion meeting for members in March, during which we will discuss initiatives and priorities for advancing equity through data collection and analytics, and we will synthesize member recommendations for further action.

We are also continuing to work on projects to increase the diversity of clinical trials, and to develop projects that focus on procurement and distribution of vaccines as well as on Medicare vaccine coverage policies to improve rates of vaccine uptake.

Expanding Access to Mental Health Care

The pandemic has also reinforced the fact that we have a behavioral health crisis in this country. We were grateful to receive a PCORI contract award that is enabling us to work with a group of payers, clinicians, and Medicaid recipients to identify research questions that will advance their ability to utilize telehealth to address behavioral health needs within the Medicaid population. We will issue a report on our findings this summer. NEHI also hosted two webinars to highlight ways to expand access to mental health care. The first, on integrating behavioral health into the primary care setting, has helped us to formulate a project with two of our members (CVS Health and Blue Cross and Blue Shield of North Carolina), which we are initiating this month. Working with experts located in various sectors of the health care industry, we will produce a guidebook for primary care practices, market innovators, policymakers, and advocates that identifies actions tailored to the level of integration different practices can realistically achieve. We are continuing to seek parties interested in participating in this project.

Our second webinar, pertaining to mental health, began exploring the potential and issues posed by a new class of psychedelic pharmaceuticals for treatment-resistant mental health conditions like PTSD and depression. We are working with some of our panelists to formulate a project that examines payment arrangements to accommodate the different models of care that these treatments require.

Healthcare Value and Payment Innovations

NEHI is continuing its work to achieve better health outcomes and greater efficiency in health care delivery by focusing on payment arrangements and processes. This year, we worked with Massachusetts providers, payers, and representatives of employer and consumer organizations over a 9-month period with funding from the Health Policy Commission and Mass Collaborative (a voluntary organization of payers, providers, and trade associations dedicated to simplification of administrative processes in Massachusetts). We published a white paper on Streamlining Prior Authorization containing consensus recommendations from the project. We also held two related briefings: In June, we co-hosted a webinar exploring innovations in prior authorization automation, and in December, five leaders from different health care sectors came together for a member briefing, Prior Authorization: Can we all be happier?, to comment on and extend the recommendations from NEHI’s white paper. We are in discussions to initiate two related projects and will provide more information on these in our next newsletter.

In another PCORI-funded project, we brought patient and payer leaders together to identify principles of effective, evidence-based, two-way communication regarding novel therapies. Project participants came together in July at a virtual conference to review and revise a statement of principles that will guide what we expect will be an increasing need for direct exchange of information among patient groups and payers as more novel therapies are approved. Findings from the conference and subsequent conversations were presented in a recently released white paper, Principles of Trustworthy Communication Among Patient Communities and Health Care Payers Regarding Novel Therapies, and were also shared in a December briefing for members.


Given NEHI’s mission, we continue to pursue projects involving innovative approaches to chronic care. A study in 2018[1] found that more than half (51.8%) of adults had at least 1 of 10 selected diagnosed chronic conditions (arthritis, cancer, chronic obstructive pulmonary disease, coronary heart disease, current asthma, diabetes, hepatitis, hypertension, stroke, and weak or failing kidneys), and 27.2% of U.S. adults had multiple chronic conditions. According to a report from the Milken Institute, in 2016, the total costs in the U.S. for direct health care treatment for chronic health conditions totaled $1.1 trillion—equivalent to nearly 6% of the nation’s GDP.[2] Those costs have undoubtedly grown. NEHI has just completed a study on multi-cancer early detection tests, and the complicated considerations the FDA must undertake in considering their approval. In addition, NEHI is working with Google Health to identify ways in which asynchronous videos are and potentially can be used to improve the difficult period of transition to adulthood for youth with diabetes. This program builds on the substantial work NEHI has done in the past on innovative approaches to diabetes care. Finally, NEHI is seeking support for a small project that examines how payment models influence obesity care. We will report on our progress in upcoming member briefings.  

Please let us know if you found this summary helpful and if we can provide additional information on any of the above-mentioned initiatives.

[1] Boersma P, Black LI, Ward BW. Prevalence of Multiple Chronic Conditions Among US Adults, 2018. Prev Chronic Dis 2020;17:200130. DOI: icon


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