Value: The Impact and What It Means to Payers
I’m Charline Shan, Vice President, Access Experience Team, editor of All Access, sharing the latest payer insights brought to you by our Access Experience Team (AET), all former access decision-makers.
Value is at the forefront for all stakeholders involved in the healthcare landscape. Is the product worth the expense? In this edition, we asked our advisors how value is defined and used to determine if the expense is justified. Ryan Cox, a recent addition to our AET, shares insights on a shift to value at an integrated healthcare system; Dan Danielson, another new member of AET, shares the inside story of how a regional health plan transitioned to a value-based formulary; Larry Blandford documents the challenges of value assessments; and Jeremy Schafer and Ami Gopalan discuss their notes on value from PCMA and AMCP.
As always, please feel free to drop me a note if you’d like more details on any of the value strategy work done by the team, or with suggestions on a topic for our next edition!
All Access is a bimonthly newsletter that features key insights from our team of former payers, intended specifically for market access leaders. It is published by Precision for Value.
Ryan Cox outlines the recent efforts of his previous employer, Highmark BCBS, and their creation of the Highmark Cancer Collective to promote evidence-based treatment pathways.
Access Experience Team member Dan Danielson documents the launch of Premera’s Value-Based Formulary (VBRx), and the development of its nontraditional tiers for defining and demonstrating value.
Larry Blandford outlines some of the key challenges payers face in relying upon value assessments, and urges greater use of structured methodologies and ongoing assessment.
AET’s Jeremy Schafer provides an overview and essential takeaways from the recent Pharmaceutical Care Management Association (PCMA) meeting, where the focus was on evolving from volume to value.
Defining and measuring value in healthcare has been a focus for both payers and manufacturers for a number of years, and this theme continued during the 2019 AMCP Annual Meeting. Ami Gopalan provides details on several high-profile sessions examining cooperation between providers, payers, and manufacturers to support optimal formulary management and deliver better patient care.