Despite the possibility of impending changes to current healthcare regulations, it appears, at least for the moment, that value-based purchasing and bundled payment plans are here to stay. As a result, hospitals and health systems must scrutinize their decision-making processes around health technology acquisitions, product standardization, and utilization management. As part of that process, it is incumbent upon both supply chain/value analysis professionals and clinicians to consider three important questions:
We’ve been seeing some talk out there about the “gold standard” when it comes to evidence assessment. Some seem to believe they’re the only ones that provide it. But when it comes right down to it, all that is…is talk.
It’s not just enough to say you use the “gold standard” for evidence assessment. You have to define it. You have to live it. You have to embody it.
This week, we were fortunate enough to have a conversation with Dr. Nierman of Tufts Health Plan, located in Watertown, MA. The Tufts Health Plan is a nonprofit organization, founded in 1979, that is nationally recognized for its commitment to providing innovative, high-quality healthcare coverage. The plan offers members and employers an array of health management programs, which support evidence-based approaches to health and wellness. Dr. Nierman has served as the Medical Director for Medical Policy for more than 18 years, and took the time to speak with us regarding why the plan made the decision to subscribe to Hayes for our unbiased evidence evaluations to better serve their health plan members.
Meaning “porous bone,” osteoporosis occurs when the body loses or makes too little bone. The appearance of osteoporotic bone under a microscope does not reveal the traditional dense “honeycomb” pattern that gives the bone stability. Instead, the patterns are almost web-like, with large holes where smaller ones would normally be, causing the bone to be quite fragile. Depending on the severity of the condition, incidents as severe as a fall to as minor as a cough can cause bones to fracture, most commonly the vertebrae (spine). And unfortunately, chances are good you know or have known someone suffering from one of these fractures.
There’s no disputing that the current state of healthcare is in flux. Regardless of public opinion and political leanings about the topic, the manner in which clinicians and health systems deliver care is changing, and more disruption to long-accepted paradigms is on the horizon. Though the move away from fee-for-service medicine has been in existence for some time, the adoption of an evidence-based approach in the provider market has been uneven at best. Perhaps now more than ever, a refocusing is required on just what evidence-based medicine (EBM) is, and why the application of the scientific method to healthcare delivery is essential to achieving the crucial Triple Aim.
2016 marked a banner year for our company. We are humbled by the loyalty of our ever-expanding client roster. At the same time, we take great pride in what we’ve accomplished over the last 12 months and we’d like to share some of those endeavors with you here. If you’re new to Hayes, or not yet a member, we invite you to view just a sample of the innovation and growth we’ve experienced as an indication of things to come.
So without further ado…
You can’t get away from the word “value” in today’s healthcare environment. It’s in practically every headline of every blog, whitepaper, and email blast. From value-analysis teams to value-based medicine and purchasing, the word has become so commonplace, it risks losing its own value. With the continued shift away from fee-for-service medicine and toward pay-for-performance, we’ll need to embrace value as not only part of our vocabulary, but as a guide for our business practices. Along those lines, I’d like to take the opportunity this week to tell you about our business values; about how they make us the obvious choice for your health technology assessments; and about how our adherence to those values cost us $100,000.
WBUR’s “Here and Now” this week featured an article regarding the use of immunotherapies to decrease allergic reactions, specifically to peanuts.
Unless you’ve been living in a cave, you’re well aware of the significant health risks peanut allergies present to individuals. Symptoms run the spectrum from a runny nose and throat itchiness to full-blown anaphylaxis, which includes constriction of the airways, a severe drop in blood pressure (shock), and loss of consciousness. While the most common cause of a reaction is eating peanuts or food that contains them, they can also be triggered by skin contact, cross-contamination during food handling, and even inhalation of dusts or aerosols containing peanuts (Source: Mayoclinic.org). An allergic response to peanuts can occur in just minutes.
With respect to health technologies, the cornerstone of any coverage policy determination requires an understanding of the following:
Does the technology work?
Is it safe?
For whom does it work?