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Characterizing health plan evidence review practices: how often, how different, and how comprehensive?
All health care decisions should be evidence-based. Until now, it has been relatively unclear what goes into health plan evidence reviews. How frequently do health plans update their specialty drug…
How the Myth of Average Persists in Health Benefits
People are different and their health needs vary. Though differences among patients are common, these differences aren’t always considered in treatment and coverage decisions.
Kimberly Westrich Talks Benefit Design with AJMC
NPC's Vice President of Health Services Research, Kimberly Westrich, MA, discusses how the healthcare system can incentivize high-value care.
NPC in Health Affairs: Payment Innovation Not Keeping Up
In a Health Affairs Blog article, NPC and MIT researchers outline how a new rule from CMS may fall short of what is needed to improve patient access to durable cell and gene therapies that target…
Avoiding Methodological Faults in Real-World Evidence
Researchers from Brigham and Women’s Hospital, Harvard Medical Center and NPC found that the potential for biased findings in RWE studies increases substantially in the absence of a rigorous and…
Walking the Walk: Taking Needed Steps to Reduce Low-Value Care
Three leading researchers detail steps to reduce low-value care in the latest edition of The American Journal of Managed Care. Their approach complements a similar effort, the Roadmap for…
What’s In Your RWE Evaluation Toolbox?
Real-world evidence (RWE) – information collected from everyday health care experiences – is growing in availability, and many health care decision-makers are interested in understanding and using…
Online Tools to Synthesize Real-World Evidence of Comparative Effectiveness Research to Enhance Formulary Decision Making
The authors describe and compare the features and characteristics of five tools to evaluate real-world evidence studies and add clarity on what the tools provide.
Racial and Socioeconomic Disparities: Ignoring Inequitable Benefit Design Is Not an Option
In a new commentary published in BenefitsPro, Kimberly Westrich, NPC Vice President for Health Services Research, and Bruce Sherman, MD, medical advisor for the National Alliance of Healthcare…
How Can Payers Advance Patient-reported Measures in Oncology, and Why Should We Care?
A peer-reviewed study describes the current state of patient-reported measures and patient-reported performance measures in oncology, the barriers to implementation, and actionable recommendations…
Addressing Low-Value Care in the Time of COVID-19
The COVID-19 pandemic has had an enormous economic impact that is being felt across our communities, businesses and the overall health care system. It has placed a larger spotlight on the challenges…
NPC Comments on CMS Best Price and Barriers to Value-Based Arrangements
NPC outlines how Medicaid Best Price poses a barrier to implementing value-based arrangements and hinders innovation in payment and delivery systems, which can make it difficult for patients to…
A Path of Her Own: Salama Freed, 2020-22 NPC/Duke-Margolis Health Policy Fellow
Salama Freed, PhD, has always wanted to learn about the inner-world of health policy – who shapes it, what drives it and how it gets done. She believes that her path to this experience is through the…
New Study Reveals Little Consistency in Evidence Cited by Commercial Health Plans for Specialty Drug Coverage
When the health care community talks about evidence-based medicine, it’s usually in the context of efforts to ensure clinicians are delivering treatments to patients that align with the best…
Six Ways to Make Real-world Evidence Methods More Transparent
Acceptance of studies based on “real-world data” remains limited, partly because the research methods used to generate usable evidence are not always transparent. That perception could change thanks…
Patients on RWE: WIIFM? (What’s In It for Me?)
In an article published in The Patient, NPC and the National Health Council found that while most patients were initially unaware of real-world evidence (RWE) and its actual or potential uses,…
Bringing Patient-Centeredness to Quality Measurement in Health Care
Quality measures can help payers to reward better care, providers to take action to improve care, and patients to make informed decisions about where to seek care. Often, quality measures are focused…
Social Determinants of Health May Be Key to Value-based Care
There is growing recognition that improving access to care and patient health, including access to medications, requires focus on social, economic and environmental factors. At its upcoming…
Journal Editors Value Real-World Evidence—With Conditions
New research from the Department of Pharmaceutical Health Services Research at the University of Maryland School of Pharmacy and the National Pharmaceutical Council reveals that real-world evidence …