The Value Lab: Moving Value-Based Health Care From Theory To Practice

19 Jul 2017

• By Susan Garfield, Michael Sherman, Roger Longman, Susan Shiff, and Ellen Licking

Although stakeholders are interested in value-based models that link a drug’s performance to emerging evidence of improved patient outcomes, such agreements are difficult to implement and too limited in scope to drive a shift to value-based reimbursement. The authors suggest a new, structured approach to bring these contracts into the mainstream, thus transforming product reimbursement and fueling the shift from volume to value.

Medical product costs remain a central concern to payers, employers and individuals in the US. Although the Trump administration has yet to issue formal policies altering drug and device reimbursement, it continues to highlight the issue via public statements and social media supporting “competition in the drug industry” and promising “pricing for the American people to come way down.”

The private sector, however, is not waiting for government-led change. US payers continue to struggle to manage costs on two...