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Stakeholders Find Step Therapy Should Be Evidence-Based, Flexible and Transparent: Assessing Appropriateness Using a Consensus Approach
Stakeholders disagree on when step therapy is appropriate, but agree on a set of criteria about how to develop, implement, communicate, safeguard and evaluate step therapy protocols.
U.S. Care Pathways: Continued Focus on Oncology and Outstanding Challenges
A peer-reviewed study assessed changes in development, implementation, and evaluation of care pathways, and reviewed the latest evidence on integration of pathways with value-based care initiatives…
Optimization of Medication Use at Accountable Care Organizations
This study assesses a broad range of factors related to how accountable care organizations optimize medication use and meet financial and quality metrics.
Health Plan Use of Patient Data: From the Routine to the Transformational
As the abundance and variety of patient data elements and sources continue to grow, health plans seek opportunities to deepen insights from multiple sources of patient data to shape care delivery,…
Improving Oncology Quality Measurement in Accountable Care: Filling Gaps with Cross-Cutting Measures
According to a study, gaps in the quality measures used by accountable care programs to assess cancer care may obscure problems in care delivery and lead to missed opportunities for improvement of…
Does a One-Size-Fits-All Cost-Sharing Approach Incentivize Appropriate Medication Use? A Roundtable on the Fairness and Ethics Associated with Variable Cost Sharing
A study convened an expert roundtable of patient, payer, and employer representatives to review four case studies to understand when it would be more (or less) acceptable to require patients with the…
The Central Role of Physician Leadership for Driving Change in Value-Based Care Environments
This case study analyzing accountable care organizations looks at lessons learned from the implementation of the American Medical Group Foundation’s Measure Up/Pressure Down initiative.
Why Is Broader Access to Publicly Funded Data Important?
This infographic illustrates the policy inconsistencies and hurdles that can hinder use of publicly funded federal and state datasets for researchers.
Using an Electronic Medication Refill System to Improve Provider Productivity in an Accountable Care Setting
This case study highlights the critical components of Sharp Rees-Stealy Medical Group's electronic medication refill system that allows for a centralized team to manage all incoming prescription…
Data, Data Everywhere, But Access Remains a Big Issue for Researchers
This study captures the policy inconsistencies and hurdles that can hinder use of publicly funded federal and state datasets for researchers. These limitations can make it harder to conduct high…
Care Pathways in U.S. Health Care Settings: Current Successes and Limitations, and Future Challenges
Care pathways, also known as clinical pathways or integrated care pathways, are typically characterized as a method for managing patient care based on clinical practice guidelines, with the main…
Solutions for Filling Gaps in Accountable Care Measure Sets
This peer-reviewed study, “Solutions for Filling Gaps in Accountable Care Measure Sets,” explores measurement gaps for high-priority conditions and identifies ways to improve measure sets.
When Does FDAMA Section 114 Apply? Ten Case Studies
There is hesitation to disseminate comparative effectiveness research because of ambiguities in the law that was established to help biopharmaceutical companies engage health plans around real-world…
Best Practices: An Electronic Drug Alert Program to Improve Safety in an Accountable Care Environment
This case study highlights the critical components of Marshfield Clinic’s Drug Safety Alert Program, which focuses on prioritizing and communicating safety issues related to medications with the goal…
Best Practices: Improving Patient Outcomes and Costs in an ACO Through Comprehensive Medication Therapy Management
This case study explores the important role that pharmacists can play in ensuring the optimal use of pharmaceuticals and improving patient outcomes in an accountable care organization (ACO). It…
Accountable Care Measures for High-Cost Specialty Care and Innovative Treatment
This comprehensive white paper from the National Pharmaceutical Council and Discern Health identified gaps in accountable care quality measure sets for cancer, which can lead to missed opportunities…
Real-World Impact of Comparative Effectiveness Research Findings on Clinical Practice
This study suggests that changes are needed to enable more consistent translation of research findings into clinical practice.