An interesting study showing that, on average, a cancer patient wastes >$4000 on unused drugs due to discontinuation of oral agents or dose modifications. Allowing a safe recycling method for patients to submit unused drugs could save a lot of wasted healthcare dollars.
Everybody’s Talking About Value-Based Health Care. Here’s What They’re Not Saying.
Nathan Walcker's Thoughts
Thought-provoking oped highlighting the underbelly of buzzwords in healthcare today. The shift from volume to value that we’ve seen unfold over the past 3-5 years has moved front and center in many conversations, yet remains elusive insofar as its definition and implementation. This article rightly calls out that value is ultimately in the eye of the beholder, and yet there’s no disputing that doing what’s right for the patient trumps all.
Attend any healthcare conference and you’ll quickly discover that it’s become downright fashionable for healthcare leaders to talk about their unwavering commitment to “value-based care.”
The expression has become ubiquitous in healthcare circles. Its virtuousness goes unchallenged.
But should that be the case?
Michael E. Porter and Elizabeth Teisberg (with whom I worked as a student and researcher at Harvard Business School from 2006-2010) popularized the value equation (Value = Quality/Cost) and suggested that improving value should be any healthcare system leader’s highest aim.
Since that time, the federal government has introduced a number of policy instruments to accelerate the transition to value-based care including Medicare Advantage, accountable care organizations, and bundled payment models.
Countless new startups have arisen with the intent of bringing value-based care to the masses.
And big box retailers such as CVS, Walgreens, and Walmart, too, have jumped on the value bandwagon.
The underlying principle of “value-based care” is simple enough—managing to a lower cost of care for a population of patients, while aiming to improve outcomes.
But what does this value-based care look like in practice in the real-world of patient care (beyond the industry conference jargon and academic expositions on the subject)?
Author AffiliationsSachin H. Jain is President and CEO of SCAN Group and Health Plan, a $3.4B non-profit entity that serves over 220,000 patients. He is also a physician at the US Department of Veterans Affairs. He was previously president and chief executive officer of the CareMore and Aspire Health, the care delivery divisions of Anthem. He is also Adjunct Professor of Medicine at Stanford University School of Medicine and Co-Editor-in-Chief, Healthcare: the Journal of Delivery Science and Innovation. Sachin trained in internal medicine at Boston’s Brigham and Women’s Hospital and received his undergraduate (AB), medical (MD), and business degrees (MBA) from Harvard.
This article provides a sweeping historical and modern day perspective on the care delivery ecosystem beyond the four walls of a hospital. While site of care (hospital, community, home, remote, etc.), and its appropriateness / value remains a hot topic of debate, there is no questioning that ultimately the best interests of the patient should govern where care is received / delivered. For oncology/hematology patients, safe, convenient and high quality / low cost care is best received in community settings, like here at Florida Cancer Specialists & Research Institute.
Compliance of National Cancer Institute–Designated Cancer Centers With January 2021 Price Transparency Requirements
While price transparency across sites of care on its face is a step in the right direction, datapoints when viewed discretely are less informative when it comes to the actual costs associated with cancer care. Additional work, analysis and research is much needed across the stakeholder continuum to fully understand the costs associated with the treatment of cancer, and to further achieve the transparency goals set forth by CMS in 2019 with this initiative.
STAT News published the below Op Ed from COA that does that highlights the dysfunction of the 340B system and how Hospital Systems and PBMs are profiting Billions of dollars a year off of a program that was intended to help underserved patients. Is a great “high level” review to help understand the overall impact on the US medical system and the importance of health care reform in this area.
Analysis of 61 NCI-designated cancers demonstrate parenteral cancer drug price markups across all centers ranging between 188.4% to 633.6%. Only 27 centers publicly disclose payer-specific prices for cancer therapies as required by federal regulation. Authors recommend public policies to discourage excessive hospital price markups on patenteral chemotherapeutics to reduce financial burden on cancer treatment for patients.