Viewpoint

Viewpoint

After decades of trial and careful use, the time has come for “telemedicine” to complete its transformation to “telehealth.” By the end of 2019, we foresee that telehealth will begin to approach mainstream use as a standard of care.

True alignment between payers and providers is the most critical success factor in securing improvements in both the cost and the quality of care. Over the last decade, progress toward this alignment has occurred, observable primarily in the many functional partnerships that have formed at the regional level.

For specialty pharmacies who are excelling at high-touch, white glove, patient care—now is the time to take these conversations forward and be the ones who bring together each of the spokes on the wheel, including biopharma partners, payers, providers, and patients—to create a differentiated, customized, and patient-centric approach to value-based care collaboration.

According to a report from the Kaiser Family Foundation, social determinants of health are “the structural determinants and conditions in which people are born, grow, live, work, and age.”

Recognizing the importance of social determinants of health, many health plans are expanding their care management capabilities to help members overcome nonmedical barriers.

In this Viewpoint, Jay Baker, Senior Vice President, Quality and Risk Adjustment Solutions, Advantmed, LLC, discusses the significant and complex proposed changes to the Medicare Advantage model which will require health plans to make significant financial and clinical changes.

Lee Horner explains how payers can invest in technology solutions that return investment and result in long-term gains. 

Value-based care contracts have the potential to significantly improve care and reduce costs, but conflicting priorities sometimes make payer-provider contracts untenable.

Greg Borca, co-founder of SKYGEN USA, discusses the future competition that will enable full coverage and drive down costs following President Donald Trump's executive order to allow health insurance to be sold across state lines.

Jim Cross, former Vice President and Head of National Medical Policy and Operations, Aetna, discusses how precision medicine is the new and emerging approach to treating patients cardiovascular disease.