1. LAN Updates: PIPC to Present at October 26 Summit; Webinar on Payment Models Focused on Low-Income and Vulnerable Populations; Guiding Committee Update, click here to register for the webinar.
2. PCORI Board Approves $83 Million for Hepatitis C Studies, Rare Disease Research, and Other Patient-Centered Studies, click here to view the press release.
3. FDA: Why Partnerships are Key to the Science of Patient Input, click here to view the post.
4. Pink Sheet: Patient Engagement Early In Drug Development Requires Cultural Shift, click here to view the article (paid subscription required).
5. Video: Marc Boutin Examines the Underutilization of Patients, click here to view the video.
6. MedPage Today: Doctors Urged to Practice 'Conservative Diagnosis', click here to view the article.
7. HHS Grants $685M to Clinicians for Patient-Centered Care: 8 Things to Know, click here to view the article.
8. Moving From Evidence-Based Medicine to Evidence-Generating Medicine, click here to view the article.
9. Forbes: Drug Price Demagoguery Could Hurt Patients, click here to view the article.
10. PCORI Blog Posts, see details below.
Regarding the October 26 Summit, MITRE states, "Join fellow innovators from health systems, health plans, consumer groups, large employers, federal, state, and local governments, experts and others who are designing or have implemented alternative payment models. At this first national stakeholder conference of the Health Care Payment Learning and Action Network, you will meet LAN Guiding Committee members, hear updates from the APM Framework and Progress Tracking Work Group, and engage with fellow APM innovators. This event is designed to support all stakeholders to successfully transition their organization or constituency to alternative payment models.” PIPC has been selected as a presenter to LAN participants. Click here to register.
The Health Care Payment Learning and Action Network (LAN) will hold a webinar on October 15 from 12:30-1:45 PM ET to provide “updates on LAN activities and hear about an innovative payment reform approach focused on low income and vulnerable populations in New Jersey. Since the last webinar, the LAN Guiding Committee is working to launch new work groups, stand up affinity groups, partner with the Core Quality Measures Collaborative on performance measures, and prepare for the first LAN Summit in Arlington, Virginia. The Guiding Committee will also hold its second in-person meeting on September 30/October 1, to continue advancing LAN goals. LAN Guiding Committee Co-Chair Mark McClellan will share updates on these activities during this webinar. In the second part of the webinar you will hear from panelists discussing the Medicaid payment reform initiative occurring in New Jersey. This model promotes accessible, coordinated, patient-centered care that focuses on health and disease prevention and reduces health care costs. Invited speakers represent Rutgers University, Camden Coalition of Healthcare Providers, UnitedHealthcare, and the New Jersey Division of Medical Assistance and Health Services to share how New Jersey has implemented this model, how the it is working, what lessons have been learned so far, and plans for evaluation and performance feedback to Accountable Care Organizations (ACOs).” Click here to register for the webinar.
Additionally, the LAN Guiding Committee held a virtual meeting on September 11. “Sam Nussbaum, chair of the APM Framework and Progress Tracking Work Group, shared the group's efforts to develop guiding principles and an APM category framework to inform the Population Based Payment (PBP) and Clinical Episodes Payment (CEP) work groups. Members supported a proposal to share this interim work with the affiliated community through the LAN collaboration portal in order to incorporate feedback from the broader LAN community early in the development process. The Guiding Committee co-chairs shared plans to partner with the Core Quality Measures Collaborative. They also updated members on selection of chairs and members for the next two work groups. CMS staff provided an update on plans to launch a purchaser and a consumer/patient affinity group in the next few weeks. Members reviewed goals and activities for expanding broad awareness about payment reform and for engaging and equipping key stakeholders. A communications and engagement plan will be provided for review at the next Guiding Committee meeting.” A detailed summary of this meeting will be posted on the Guiding Committee page.
To join the LAN and receive updates about activities, including opportunities for input and participation, click here.
2. PCORI Board Approves $83 Million for Hepatitis C Studies, Rare Disease Research, and Other Patient-Centered Studies
According to a recent press release, “The Patient-Centered Outcomes Research Institute (PCORI) Board of Governors today approved $83 million to fund 26 patient-centered, comparative clinical effectiveness research (CER) studies on a range of conditions and patient populations. Two of the new awards totaling $29.5 million will support studies on caring for people infected with hepatitis C virus (HCV). In addition, awards totaling nearly $7.4 million will fund research on rare conditions in response to PCORI’s offer of a special pool of funding to support rare disease research. The Board also approved PCORI’s development of targeted funding announcements on treatment of people with multiple sclerosis (MS) and long-term opioid use for chronic pain… ‘We heard from many people—including individuals with hepatitis C as well as clinicians who treat them, the pharmaceutical industry, payers, and others—that with the great promise offered by new antiviral medications, there are also many questions about hepatitis C therapies and care delivery that need to be answered,’ said PCORI Executive Director Joe Selby, MD, MPH. ‘As the availability and use of the new antiviral medications increases, we're pleased to support patient-centered CER that will help clinical decision makers to make better-informed choices about hepatitis C treatment and care.’” Click here to view the press release.
As detailed in a report from BioCentury, “PCORI said two awards totaling $29.5 million will fund studies of HCV care. PCORI spokesperson Christine Stencel told BioCentury the PCORI-funded PRIORITIZE study will compare effectiveness and side effects in HCV genotype 1 patients treated with Harvoni ledipasvir/sofosbuvir from Gilead Sciences Inc., Viekira Pak from AbbVie Inc. and grazoprevir/elbasvir (MK-5172/MK-8742) from Merck & Co. Inc.. The study will also evaluate treatment adherence, out-of-pocket costs and other patient outcomes.” Click here to view the article.
3. FDA: Why Partnerships are Key to the Science of Patient Input
In a blog post on FDA Voice, Nina L. Hunter, Ph.D., a Special Assistant for Medical Policy to the Office of Medical Products and Tobacco, andRobert M. Califf, M.D., is FDA’s Deputy Commissioner for Medical Products and Tobacco, comment that the agency “recently announced the first FDA Patient Engagement Advisory Committee (PEAC), supported by the Center of Devices and Radiological Health (CDRH). The Committee will provide advice to the FDA Commissioner on complex issues relating to medical devices, the regulation of devices, and their use by patients. The PEAC will bring patients, patient advocacy groups, and experts together for a broader discussion of important patient-related issues, to increase integration of patient perspectives into the regulatory process, and to help drive more patient-centric medical device innovation, development, evaluation, and access… With the PEAC offering an important avenue for patient views to be incorporated in the assessment of new medical devices, complementary programs in the Center for Drug Evaluation and Research (CDER) and the Center for Biologics Evaluation and Research (CBER) are continuing to explore multiple approaches to patient involvement in development programs for drugs and biologic products, respectively.” Click here to view the post.
4. Pink Sheet: Patient Engagement Early In Drug Development Requires Cultural Shift
An article in The Pink Sheet reports that “the science of patient preferences and patient outcomes is neither universally well-recognized nor well-regarded, according to the [National Health Council and Genetic Alliance] report. ‘Approaches and methods for engaging patients and obtaining their perspectives are not widely regarded by researchers as scientifically robust or methodologically rigorous,’ the report states. ‘Instead, patient perspectives are largely perceived as being anecdotal, emotional, and in many cases subjective as compared to clinical outcomes data obtained in clinical trials.’” Click here to view the article (paid subscription required).
5. Video: Marc Boutin Examines the Underutilization of Patients
In a new video posted by The American Journal of Managed Care, Marc Boutin, CEO of the National Health Council, comments that the healthcare system in the US makes it nearly impossible for patients and physicians to form a real relationship, and patients are rarely asked about what's going on in their lives, which could inform treatment. Click here to view the video.
6. MedPage Today: Doctors Urged to Practice 'Conservative Diagnosis'
As MedPage Today reports, “Internist Gordon Schiff, MD, says there's one thing he gives his patients that helps them deal with uncertainties in diagnosis: his cell phone number… Allowing for uncertainty in diagnosis is just one part of a practice style that Schiff is calling ‘conservative diagnosis’ -- a term that means more than just ordering fewer tests. ‘We need to do the right thing for the right reason,’ he said. ‘We don't just need fewer tests, but also more appropriate testing and better care.’ Conservative diagnosis is based on respect for clinical challenges, uncertainties, anxieties, and ways clinicians and patients can work together to improve care and outcomes, he said, noting that the idea was an outgrowth of a similar movement called ‘conservative prescribing’ that Schiff and colleagues published in the scientific literature 4 years ago.” Click here to view the article.
7. HHS Grants $685M to Clinicians for Patient-Centered Care: 8 Things to Know
Nearly 40 national and regional healthcare networks and supporting organizations will receive $685 million to improve patient care as part of the federal government's initiative to overhaul payment methods for medical providers, according to a recent announcement from HHS. Becker’s Healthcare reviews the eight things you need to know about the grants: “(1) The grants, unveiled Tuesday and funded under the Affordable Care Act, are designed to help equip more than 140,000 clinicians with the tools and support needed to improve the quality of care, increase patients' access to information, and reduce costs… (2) HHS Secretary Sylvia M. Burwell [said] ‘these awards will give patients more of the information they need to make informed decisions about their care and give clinicians access to information and support to improve care coordination and quality outcomes.’ … (7) The American Board of Family Medicine will work with more than 25,000 family physicians to help both clinicians and patients navigate the changing healthcare system, reduce disparities in healthcare and move toward a wellness-based approach to managing care.” Click here to view the article.
8. Moving From Evidence-Based Medicine to Evidence-Generating Medicine
As reported in Healthcare Informatics, “at last week’s AcademyHealth’s Concordium 2015 meeting in Washington, D.C., several themes emerged around how to better include communities of patients in research, how to use patient-reported outcome data, and how to move toward the systematic incorporation of research and quality improvement into the organization... [Peter Embi, M.D., of Ohio State University's College of Medicine] and others have been arguing for moving from ‘evidence-based medicine’ to an ‘evidence-generating medicine’ approach, which he defined as the systematic incorporation of research and quality improvement into the organization. Rather than findings flowing only from research done looking back at historical data, this approach creates a virtuous cycle where clinical practice is not distinct from research.” Click here to view the article.
9. Forbes: Drug Price Demagoguery Could Hurt Patients
As Robert Nelsen commented last week in Forbes, “But there is a downside to politicking with a broad brush. When lawmakers demagogue the price issue alone with talk of price caps and controls, markets crash, money for innovative cures dries up, clinical trials get pushed off, and people waiting for cures actually die. Yes, they die. When you are sick, weeks and months matter. Real unintended consequences that impact real innovators, real patients and actually penalize those who are necessary to reduce healthcare costs by inventing and financing the development of more effective therapies… We need a real conversation about ‘pay for performance,’ where drugs that can prove their worth are reimbursed more. We also need real recognition that is it fine to reward innovators generously for creating drugs that cure people and save money. We should make no apologies for a $100,000 drug that can prove it saves society money and treats Alzheimer's.” Click here to view the article.
10. PCORI Blog Posts
A series of new posts on The PCORI Blog last week address PCORI’s (1) progress through five years, (2) patient-centered outcomes research as “a brave new world,” and (3) PCORI-funded research targeting older adults. In the first post, PCORI Executive Director Joe V. Selby, MD, MPH, comments “Our process for funding stakeholder-driven research has led to a portfolio of 468 projects so far, many focusing on patient populations, topics, and outcomes that traditional research has not adequately addressed. It will be a few years before most of those studies are finished, analyzed, and have results available—rigorous research takes time, after all. But information from some of our funded studies is starting to emerge and offering a sense of how our approach can work and have an impact in practice.” Click here to view the post. In the second post, Planetree’s Susan Frampton, PhD and Sara Guastello comment, “for Patient-Centered Care Awareness Month (and beyond), we're encouraging the courageous pursuit of patient-centered outcomes research (PCOR). The Patient-Centered Outcomes Research Institute (PCORI) bases its mission on the idea that engaging patients and other healthcare stakeholders throughout the research process increases the likelihood that a study's results will be useful in improving clinical practice and providing the evidence that patients need to participate in their own care.” Click here to view the post.
In the third post, PCORI’s Kelly Dunham, MPP and Steven Clauser, PhD, MPA, The PCORI Blog comment, “As we wrap up Healthy Aging Awareness Month, we are highlighting PCORI-funded projects focused on improving care for older adults and helping people to age with dignity. Our authorizing law directs us to pay particular attention to health problems that disproportionately affect certain populations, including older adults. We also are charged with focusing on conditions that affect many people and place a significant burden on society, areas rich in opportunities for improving care of older adults. Requiring that older adults be partners in all of the aging-focused projects we fund is part of our commitment to patient-centered outcomes research that can help patients and those who care for them make better-informed healthcare decisions.” Click here to view the post.