Browsing “GovernmentGovernment | EVERSANA”

Population Health Partnerships To Advance Value-Based Care

The business model for health care in the United States is evolving from a volume-driven model to a consumer-centric, value-driven model. As such, there are new competencies required of hospitals and health systems to effectively manage a population’s health across the continuum of care. Many hospitals and health systems will need to partner with other […]

Navigate the Complexity of Proposed CMS Medicaid Rule

In this presentation at MDRP’s virtual summit, Mike Kurland discusses several key regulatory proposals and executive orders and the impact on pharma: Operationalizing Value-Based Contracting – Has the door been opened, and how do we prepare for an increase in value-based strategies? Managing Coupons and Vouchers – Do we have the right data, and what […]

CMS Announces Medicare Coverage for FDA-Designated Breakthrough Devices. What Does This Mean?

On August 31, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule change that would automatically provide national Medicare coverage for FDA-designated Breakthrough Devices for a four-year period immediately upon FDA approval. This is big news for patients, health care providers and medical device manufacturers. When the Breakthrough Devices program was […]

The Regulatory Landscape in Digital Health

Despite the advances in digital health and digital therapeutics in recent years, there remains an ambiguity in the digital space and uncertainty surrounding regulation and reimbursement of digital technologies applied to pharma, biopharma and medical device companies. In an insightful conversation that was part of EVERSANA’s Digital Symposium, Ed Cox, Executive Vice President, Strategic Alliances […]

Where Health Systems are in the Shift to Value: Four Categories

One could make the argument that there are four situational categories under which all health systems now fall on the journey toward more value-based care and away from the fee-for-service model. Assisting health systems in successfully transitioning to value-based care and delivering improved clinical and financial outcomes for their patient populations depends on very different […]

How COVID-19 will Change the Patient Journey, Reimbursement, and Care Delivery

Value-based care has led to much change in healthcare over the years, and COVID-19 is pushing change faster and even further. These changes forced by COVID-19 will have long-term effects on every aspect of care delivery; current healthcare tools and programs such as clinical pathways need to adjust to these changes to continue being helpful. […]

Clinical Pathways and Policy to Guard Against Misaligned Incentives

The application of clinical pathways and their enforcement through quality metric benchmark setting and appropriate use criteria is needed to guard against perverse financial incentives that encourage overutilization and underutilization. Moving forward, the more diligent payers and integrated delivery networks can be in evaluating and incorporating utilization criteria when establishing clinical pathways, the better off […]

European Pricing Platform: The State of International Reference Pricing

Worldwide, pricing policy is always in flux. In this webinar, EVERSANA’s General Manager of Global Pricing and Access, Alan Crowther, examines global trends impacting the International Reference Pricing (IRP) landscape and discusses the possible effects these could have on the United States’ proposed International Pricing Index (IPI). In this discussion, Crowther looks beyond the in-country […]

Pathways for Paying for Rare Disease Treatments

This article was written for the Journal of Clinical Pathways Determining how to pay for the treatment of uncommon yet serious diseases is an important consideration in terms of sustainability and patient access. Novel and expensive therapies will create financial pressure for payers’ drug budgets. Clinical pathways have demonstrated success at determining the “right treatment […]