An interest Health Affairs blog post on outcomes-based pricing from Daniel M. Blumenthal Samuel Nussbaum Neil J. Weissman and Mark Linthicum.
Insurers are increasingly tying health service payments to clinical outcomes to improve care value and quality. Outcomes-based pricing—setting treatment reimbursements to reflect their prospectively determined value to patients and the health care system—is a promising alternative payment model for promoting higher-value care. While use of outcomes-based pricing agreements (OBAs) for pharmaceuticals has increased, to date there has been little focus on using OBAs to promote shared clinical and financial accountability for medical devices.
In this post, we explore the potential use of OBAs for medical devices used to treat cardiovascular disease (CVD). We highlight the need for innovative reimbursement systems that promote accountability for CVD device outcomes, outline challenges associated with device OBAs that must be overcome to promote their adoption, and describe a hypothetical OBA for percutaneous coronary intervention (PCI) for patients with stable angina.
Do read the whole thing. The article was funded by the Innovation and Value Initiative (IVI), where I serve as the Director of Research.