Voices in Health Care Value - December 2019

Welcome to the sixth issue of Voices in Health Care Value, the newsletter of the Research Consortium for Health Care Value Assessment (RC-HCVA). This issue features work from our colleagues at the Innovation and Value Initiative. We appreciate your comments and inputs to subsequent issues. If you are interested in becoming a Colleague in Value (individuals and groups who work in this area or who are simply interested in its findings) please register here.

LEAD ARTICLE

The Research Consortium for Health Care Value Assessment Speaking Engagements

By George Miller and Beth Beaudin-Seiler

One of the objectives of the Research Consortium for Health Care Value Assessment (RC-HCVA) is to disseminate the work of the consortium and that of our Colleagues in Value for use by other researchers and practitioners interested in these findings. (This newsletter is one of the vehicles we use for that purpose.) In November of this year, RC-HCVA team members presented some of our work at two conferences that addressed issues in value assessment.

The ISPOR Europe 2019 conference, held November 2-6 in Copenhagen, Denmark, convened over 5500 global healthcare stakeholders and thought leaders. Representing more than 90 countries, participants included researchers, academicians, assessors and regulators, payers and policymakers, representatives from the life sciences industry, health care providers and patient engagement organizations. RC-HCVA was there, in an educational panel session entitled “Go Where the Money Is” – Capturing Value Across the Health Care System. The panel, made up of U.S. and U.K. experts, discussed focusing on value in the health care system. Dr. Beth Beaudin-Seiler from the RC-HCVA discussed what is contributing to the rising health care costs in the United States, and how robust measurement strategies can help focus our attention and resources. Dr. William Padula from USC discussed how these different strategies can be used in discussions with various stakeholders in order to resonate and drive change. Finally, Adrian Towse from the Office of Health Economics in London offered a look at what has been the focus of measurement strategies in the U.K. (noting the current emphasis on the value of pharmaceutical services), and where further focus should be placed. The attendance of the ISPOR Europe conference was the largest to date.

On November 12, the PhRMA Foundation and the National Health Council held a conference in Washington, DC on The Next Generation of Value Assessment: Including the Patient Voice. Among the presentations were three panel discussions that addressed the topic of “Moving Beyond Traditional Approaches to Value Assessment.” In the first panel, representatives of four PhRMA Foundation grant recipients summarized their work in value assessment. In addition to Dr. George Miller, co-director of RC-HCVA, panelists included Dr. Susan dosReis of the Center for Patient-Driven Values in Healthcare Evaluation (PAVE), Dr. Jon Campbell of Pharmaceutical Value (pValue), and Dr. Peter J. Neumann of the Center for Enhanced Value Assessment (CEVA). Subsequent panels reacted to the presentations of the first panel. The second panel included the reactions of other value assessors and emphasized the need for new methods for value assessment. The third panel consisted of stakeholders who discussed how value assessment research translates into practical application in the health care system. A slide deck of all the presentations at the conference can be found here.

RESEARCH CORNER – In Case You Missed It

The newest concept paper from the Research Consortium for Health Care Value Assessment discusses the need to measure low-value care at a state-level as well as at the national level. Read the full paper here.
In a recent research article in JAMA, William Shrank and colleagues updated some very important work on the level of waste in the U.S. health care system. They found that upwards of 25% of the total health care expenditures in the U.S. are wasteful, equating to roughly $800 billion annually. Their work also included what could be saved if evidence-based strategies to reduce waste were scaled and implemented nationally, they suggest nearly $282 could be eliminated. Read the full article here.
In a recent Op-Ed in MedPageToday, Dr. Pezalla discusses the imbalance of value assessment and points to the work of the Research Consortium and others to focus on what is contributing to the rising cost of health care rather than what is easy to measure. Read full article here.
In a recent research article in Journal of General Internal Medicine, Carlos Oronce and Robert Fortuna examine the performance of Community Health Centers compared to private practices on a comprehensive set of high-and-low-value care measures, suggesting that Community Health Centers perform similarly to private practices and could be a source of high-value healthcare. Read full article here.
In a recent AcademyHealth blog post, Lisa Simpson and Paul Armstrong discuss the need to focus on vulnerable populations in the broader effort to reduce low-value care. Read full blog here.

THE COMMUNITY – A Spotlight Feature on a Colleague in Value

Each issue will spotlight work by a Colleague in Value. This issue’s spotlight is on the Lown Institute.

The Lown Institute

The Lown Institute is a non-profit, nonpartisan think tank focusing on health and health care. Our vision is a country where all people have the opportunity to be as healthy as they can be, and we believe a radically better American health system is both needed and possible. Our work centers on four main areas: health care value; health equity; accountability; and healing and the human connection. Led by Dr. Vikas Saini, a clinical cardiologist and former Harvard Medical School faculty, and Shannon Brownlee, an author and university lecturer, the Institute conducts research, convenes experts, and sparks public debate to bridge the gap between existing public policy solutions and the care that Americans want and need. We are known for our unique national conferences, groundbreaking Lancet series on overuse and underuse around the world, and annual Shkreli Awards, named for the infamous “pharma bro,” Martin Shkreli.

In January 2020, the Lown Institute will release an action plan addressing the epidemic of medication overload among older Americans. (Medication overload is often referred to as polypharmacy in the medical literature.) The culmination of a two-year project identifying the scope and drivers of medication overload and solutions to it, the plan highlights five key reforms:

Implementing prescription checkups—regular medication reviews designed for deprescribing unnecessary or harmful medications;
Raising awareness about medication overload among both clinicians and patients;
Educating and training health professionals to deprescribe and prescribe appropriately;
Improving information at the point of care, such as incorporating deprescribing information into clinical practice guidelines;
Reducing pharmaceutical industry influence.

Later in 2020, the Institute will release the results of a hospital ranking project that examines institutional performance based on patient outcomes as well as several novel metrics, including social impact.

UPCOMING EVENTS

Submission for abstracts to Academy Health 2020 ARM Conference, due by 5:00pm ET, January 9, 2020. Submit here.
Submission for abstracts to ISPOR 2020, due by January 15, 2020. Submit here.

PAST EVENTS

The 2019 Sustainable Health Care Spending Symposium took place this past July 2019 with incredible information and speakers. The full monograph can be found here.