CEO Blog/06.29.17


AMCP_Beyond 

Susan A. Cantrell, RPh, CAE

 

 


Leading on Today’s Most Pressing Challenges: AMCP Partnership Forum Develops Action Plan for Advancing Value-Based Contracting

 

  
Value Forum Photo 
 
 

June 29, 2017 

One of the many things that I’m proud of at AMCP is our role as a convener. We bring together several times a year key stakeholders representing a diverse range of positions to address common health care challenges.

We fulfilled that role recently at our Partnership Forum on Advancing Value-Based Contracting.

The June 20-21 event in Arlington, Va., brought together nearly 40 experts from managed care pharmacy, provider groups, integrated delivery systems and the biopharmaceutical industry to discuss strategies for expanding the use value-based contracting. The two-day event resulted in important consensus on how to address the operational, legal and regulatory changes needed to fully leverage the potential of value-based contracting. 

The June 20-21 event in Arlington, Va., brought together nearly 40 experts from managed care pharmacy, provider groups, integrated delivery systems and the biopharmaceutical industry to discuss strategies for expanding the use value-based contracting. The two-day event resulted in important consensus on how to address the operational, legal and regulatory changes needed to fully leverage the potential of value-based contracting.

Value-based contracting, as many know, is a model that moves away from payments based solely on volume or market share and towards payments based on pre-approved criteria aimed at improving patient outcomes and ensuring appropriate use of health care resources. .

A decade ago, the idea of linking the cost of a therapy to its performance was considered revolutionary. Today, value-based care is considered a key solution to improving patient care while better managing costs. In fact, in this era of fierce debate over the future of our health care system, one area of agreement is that we develop models to pay for products and services based on how well they perform.

Our forum on this topic comes at an opportune time. The White House reportedly is expected to issue an executive order on pharmaceutical pricing that will encourage the use of value-based contracts. And recent Congressional scrutiny on escalating drug costs underscores the urgency we face in increasing the value that pharmaceuticals deliver to patients.

AMCP is taking a leadership role to ensure that all stakeholders who have a role in value-based contracting will be able to support and/or implement the model.

But as with many things in health care, getting to this new model will be a challenge. AMCP forum participants considered such complex topics such developing a definition for value-based contracting; understanding performance metrics and measures for value; developing solutions for patient management-related hurdles; identifying therapeutic areas that represent “early adoption” opportunities; and addressing legal and regulatory changes that would drive the adoption of these contracts, including those related to anti-kickback laws and Medicaid best price requirements.

The recommendations that emerged from this forum will be published in the fourth quarter 2017 in AMCP’s Journal of Managed Care and Specialty Pharmacy and presented during a webinar in October.

I am proud that AMCP is at the forefront of this effort. We don’t have 10 years to build new processes and systems to move toward value-based care, we must drive these changes today.