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Value, Quality, and Reimbursement

Value, Quality, and Reimbursement provides insights on expected changes in value assessments, quality initiatives, and provider reimbursement over the next three years, assisting companies with anticipating evolving access opportunities and risks for brands.

  • What impact do HEOR, RWE, and value assessments have on payer decisions?

  • What is the overall level of success for value-based contracts, and which contract terms are predictors of highly successful contracts?

  • Which therapeutic areas do payers and IDNs target with quality improvement efforts, creating need for support?

  • What types of company programs most effectively support payer quality improvement efforts?

  • Which CMS Innovation Center demonstrations have most impact on company business with payers and IDNs?

Use Value, Quality, and Reimbursement to:

  • Identify value assessments that influence payer decisions, and assess impact on formulary access
  • Identify best practices in value-based contracting between companies and payers
  • Anticipate the emergence of innovative payment models as company relationships with providers evolve
  • Assess plan and IDN performance on various quality metrics, and identify therapeutic areas with significant opportunities for engagement
  • Assess the impact of programs from the CMS Innovation Center on payer and IDN behavior
  • Value-Based Access Decisions March
    • Use and impact of HEOR and RWE in access decisions
    • Organizations providing value assessments, and data that they utilize
  • Company-Payer Value-Based Contracting Trends May
    • Prevalence and level of success payer achieve in value-based contracts
    • Therapeutic areas with greater inclusion in value-based contracts
    • Barriers to successful participation in value-based contracts
  • Customer Perceptions of Quality Information and Programs June
    • Best quality program partnerships, and key components of these relationships
    • Benchmarking of biopharmaceutical company quality programs
  • Innovative Payment Model Evolution July
    • Innovative models with widest customer adoption, and company opportunities to partner
    • Level of risk and success in innovative payment models
  • CMS Innovation Center Payment Model Influence September
    • CMS Innovation Center demonstration uptake by IDNs and payers, and influence on payer access decisions
  • Quality Performance and Priorities October
    • Prioritization and level of success of quality metrics by customers
    • Therapeutic areas with greatest impact from quality metrics
  • Company-IDN Value-Based Contracting Trends November
    • Prevalence and type of value-based agreements between IDNs and companies
    • Impact of value-based agreements on product access

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