1. PIPC Launches New Website!, click here to view the site.
2. PIPC Submits Letter to HHS on Oregon Medicaid Health Plan Extension, Calls for Patient Engagement and Critiques Use of QALYs, click here to view the letter.
3. JAMA: Tailoring Complex Care Management for High-Need, High-Cost Patients, click here to view the article.
4. Policy and Medicine: Value Frameworks: Are They the Way of the Future? click here to view the article.
5. The Hill: Getting it Right on Value Frameworks, click here to view the blog post.
6. HHS Announces Winners of Challenge to Improve Medical Bills for Patients, here to view the press release.
7. The Pink Sheet: As Drug Value Frameworks Gain Traction, Patients Seek More Input, click here to view (subscription only).
8. Video: Dr. Kate Goodrich Discusses Success of CMS Move to Value-Based Payment, click here to view the video.
9. Video: Dr. Leonard Fromer on Personalized Versus Precision Medicine, click here to view the video.
10. Medical Journal Articles, see details below.
11. Upcoming Events and Webinars, see details below.
12. AHRQ Effective Program Updates, see details below.
Today, PIPC is launching a new website that highlights the Partnership’s work to give patients a seat at the table in the evolving healthcare landscape. The redesigned and revamped website aptly highlights PIPC's work to amplify the voice of the patient in three key areas in the discussion of value-based care: (1) implementing value-based payment, (2) developing and using tools to inform decisions on care value, and (3) supporting research on comparative value.
Among the key resources available on the new PIPC website (www.pipcpatients.org):
- An updated ‘Issues’ page which highlight’s PIPC’s previous work in the three key areas of focus;
- A new ‘Where We Stand’ page, which summarizes PIPC’s positive, forward-thinking agenda for how to include the patient voice at the center of the evolving healthcare landscape;
- An action-oriented call-to-action – the Patient Voices, Patient Value Initiative – which calls on patients to engage with policymakers in the development of “value” policies;
- A revamped ‘Resources’ page – a sortable compendium including all of PIPC’s roundtable outputs, white papers, letters and comments, and polling data;
- The PIPC Blog, which includes everything from our ‘PIPC Patients Blog’ posts, the ‘Chairman’s Corner,’ recent news items, recent press releases, and all of our previous ‘PIPC Weekly Updates.’
2. PIPC Submits Letter to HHS on Oregon Medicaid Health Plan Extension, Calls for Patient Engagement and Critiques Use of QALYs
Last Friday, PIPC Chairman Tony Coelho sent a letter to the Department of Health and Human Services (HHS) expressing concerns with a proposed extension of Oregon's Medicaid Health Plan Extension. Currently, Oregon has a unique waiver from “EPSDT” – a foundational principle of Medicaid that makes health care for children a national priority, and specifically requires coverage of “all medically necessary diagnostic and treatment services." The system underlying the Oregon Health Plan is a prioritized list of services, that uses measures such as quality-adjusted life-years (QALYs) to determine access to services.
In the letter, Chairman Coelho states that "As chair of PIPC, I have made it my ministry that patients and people with disabilities must have a meaningful voice in the development of health policies, particularly in the discussion about what constitutes “value” in health care. Yet, what I have learned from the families of autistic children in Oregon is that they are not at the table and their perspectives of valued services for their children are not being taken into consideration... I have been very vocal, along with all my colleagues representing people with disabilities, about my concerns with the use of measures of cost effectiveness and particularly quality-adjusted-life-years (QALYs) to determine value. It has been our experience that these types of measures of value often conclude that we are not worth it, that our lives are not valuable. As a result, we are denied access to needed health care." Click here to view the letter.
3. JAMA: Tailoring Complex Care Management for High-Need, High-Cost Patients
In a recent opinion piece published in The Journal of the American Medical Association (JAMA), authors urge lawmakers to extend funding for the Patient-Centered Outcomes Research Institute (PCORI), especially as it relates to improving the care of high-need, high-cost patients. As the author’s note, “The next administration and US Congress should consider extending funding for the Patient-Centered Outcomes Research Institute with direction to test the comparative effectiveness of innovative care approaches for HNHC patients. Medicare, Medicaid, and other health care programs have protean effects on the welfare of US residents, the nation’s economy, and governmental budgets. Responsible governance requires that new federal leaders prioritize the improvement of these health programs, with a laser focus on HNHC patients and their needs.” Click here to view the article.
4. Policy and Medicine: Value Frameworks: Are They the Way of the Future?
A recent article in Policy & Medicine highlights the potential dangers that value frameworks can have on patients, including those developed by the American Society of Clinical Oncology, the Institute for Clinical and Economic Review, the National Comprehensive Cancer Network, and Memorial Sloan Kettering Cancer Center. “Interestingly, a survey conducted by Avalere Health found that out of eleven health plans surveyed, none of them rely on the new tools, and a majority do not expect to do so next year, either. According to the survey, the plans would like to see the provider community embrace the frameworks before formally adopting them into their decision-making process,” the article states. “It is possible that these frameworks have the potential to be as dangerous to patients as Open Payments. As we have learned, more information is not always beneficial, and it can oftentimes add to the confusion many patients already feel about their health care treatment.
We urge extreme caution when it comes to these frameworks, in part because it is hard to generalize and predict the value of medications to individual patients.” Click here to view the article.
5. The Hill: Getting it Right on Value Frameworks
In a recent blog post published in The Hill, Former Rep. Jim Greenwood (R-PA) comments, “Relying on a single voice from a single perspective – like ICER’s, which tries to assess the value of new-to-market medicines based on limited clinical data and incomplete (or nonexistent) pricing data – will not provide the answers to the serious questions that make value assessment an important tool. Instead, it can lead us down the path of delaying or denying patient access to needed medicines and stifling future, better innovations. That would be particularly short sighted, given that innovative medicines are one of the best opportunities to reduce total healthcare expenditure over the long term.” Click here to view the blog post.
6. HHS Announces Winners of Challenge to Improve Medical Bills for Patients
Last week, the Department of Health and Human Services (HHS) announced the winners of the HHS "A Bill You Can Understand" challenge, a design and innovation challenge to solicit new approaches and draw national attention to a common complaint with the health care system: that medical billing is a source of confusion for patients and families. HHS received submissions from health care organizations, technology companies, and design agencies, and last week unveiled the two winning designs, which will be further evaluated for testing or implementation in six health care organizations across the country that are working to improve the patient billing experience. After receiving more than 80 submissions, the challenge awarded two prizes for: 1) the bill that is easiest to understand; and 2) the design that best improves the overall approach to the medical billing system, focusing on what the patient sees and does throughout the process. Click here to view the press release.
7. The Pink Sheet: As Drug Value Frameworks Gain Traction, Patients Seek More Input
RealEndpoints CEO Roger Longman suggests in a recent article in The Pink Sheet that “any value framework that is going to be accepted and used has to reflect multiple points of view around value definition. If it can't do that, it will not be used.” He explains that different points of view can be accommodated by “customizing the weights of each of the elements to reflect the relative importance within your decision-making. There is no one-size-fits-all analysis.’” Click here to view (subscription only).
8. Video: Dr. Kate Goodrich Discusses Success of CMS Move to Value-Based Payment
In a video by The American Journal of Managed Care, Dr. Kate Goodrich, Director of the Quality Measurement and Value-Based Incentives Group of Centers for Medicare and Medicaid Services (CMS) shares the reasons why she believes CMS reached its 2016 goals for transition to value-based payments early. “I think we were able to do this because there have been so many collaborators and partners out there who have been really excited about joining in with the alternative payment models that the Innovation Center had out there,” she says. Click here to view the video.
9. Video: Dr. Leonard Fromer on Personalized Versus Precision Medicine
Speaking in a video posted by The American Journal of Managed Care, Dr. Leonard Fromer, Executive Medical Director of the Group Practice Forum explains the difference between personalized medicine and precision medicine. “Personalized medicine looks at a patient’s genome, but precision medicine takes more of their social and individual determinants into account,” he says. Click here to view the video.
10. Medical Journal Articles
Neuraxial vs General Anaesthesia for Total Hip and Total Knee Arthroplasty: A Systematic Review of Comparative-Effectiveness Research, click here to view.
11. Upcoming Events and Webinars
LAN Webinar: Building a Robust Data Infrastructure that Supports APMs
October 5, 2016, 2:00PM ET
Click here for details.
Cycle 3 2016 Treatment of Multiple Sclerosis Applicant Town Hall
October 11, 2016, 11:00AM - 12:30PM ET
Click here for details.
Cycle 3 21016 Clinical Strategies for Managing and Reducing Long-Term Opioid Use for Chronic Pain LOI Town Hall
October 11, 2016, 12:30 - 1:30PM ET
Click here for details.
Translational Products for Systematic Reviews: A PCORI Stakeholder Workshop
October 14, 2016, 9:00AM - 3:00PM ET
Click here for details.
PCORI: Advisory Panel on Addressing Disparities Fall 2016 Meeting
October 24, 2016, 9:00AM - 5:00PM ET
Click here for details.
Measuring Our Impact on Science, Delivery of Care, and Patient Outcomes
October 27 - 28, 2016
Click here for details.
Recommendations of the Second Panel on Cost-Effectiveness in Health and Medicine
December 7, 2016, 9:00AM - 4:30PM
Click here for details.
12. AHRQ Effective Program Updates
Management of Uterine Fibroids, click here to view.
Newer Medications for Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia -- Disposition of Comments, click here to view.
Resident Safety Practices in Nursing Home Settings -- Disposition of Comments, click here to view.
Total Worker Health® (TWH) -- Disposition of Comments, click here to view.
Disparities Within Serious Mental Illness -- Disposition of Comments Report, click here to view.
Fractional Exhaled Nitric Oxide Clinical Utility in Asthma Management -- Research Protocol, click here to view.
Anxiety in Children -- Research Protocol, click here to view.
The Role of Immunotherapy and the Management of Asthma: Systematic Review -- Research Protocol, click here to view.
Treatment of Primary and Secondary Osteoarthritis of the Knee: An Update Review, click here to view.
Systematic Review of Intermittent Inhaled Corticosteroids and of Long-acting Muscarinic Antagonists for Asthma -- Research Protocol, click here to view.
Outcome Measures Framework: Literature Review Findings and Implications - Final Report, Click here to view.