As accountable care organizations, bundled payments and other value-based payment models sweep the nation, NEHI works to uncover implications for innovation.
A shift to value-based care has created a new environment for innovation: health care delivery systems and payers are now seeking innovations that not only improve care, but can also meet their financial and quality targets. This new environment has significant implications for innovations, including how they are accessed, delivered and measured.
In October 2015, NEHI and The Deloitte Center for Health Solutions hosted a meeting with NEHI members and other stakeholders from across the health care system to identify changes necessary for innovation to be properly integrated into care in a new, value-based environment.
Read the full summary of the meeting and findings here.
Meeting participants identified four recommendations that need to be addressed by the health care community that have also been addressed by some of NEHI’s past and current work:
- Adopt a broader set of quality measures: Participants identified that quality measures in new payment models need to be more patient-centered and tied to longer-term outcomes. Life sciences companies should look for ways to increase their participation in cross-sector groups currently working to improve these measures.
- Improve data availability, transparency and integration: Participants recognized that data must be shared across sectors to better understand how products perform in real world settings; however, there are many issues in sharing data, including regulatory restrictions that life sciences companies have generating and communicating data.
- Redefine unmet and under-met needs: Participants also identified that life sciences companies can be partners in care delivery. They can deliver services focused on improving clinical process and financial goals, and collaborating with their customers to better understand unmet and undermet needs of their patient populations. However, regulatory barriers exist for these partnerships, such as the Anti-Kickback Statute.
- Share financial risks between life sciences companies and their product purchasers: As providers and payers begin to share financial risk, there should also be alignment between decision-makers on criteria used for evaluating products. Additionally, life sciences companies should engage in more value-based purchasing agreements with payers to help expedite patient access to innovation and more effectively demonstrate real world impact of innovations.
The full summary of the meeting and findings can be found here.
If you’d like to learn more about these issues or how you can participate in future NEHI meetings e-mail us. Or, join us for our annual meeting where we'll be covering many of these topics.