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One reason to embrace shift away from healthcare’s fee-for-service model: Better drugs

As much as people have been talking about the upcoming shift away from the fee-for-service model of healthcare, in most cases it’s an abstract concept as it’s still years away from being implemented by providers, with a few notable exceptions. But in a panel discussion at the Eye for Pharma conference this week, a medical […]

As much as people have been talking about the upcoming shift away from the fee-for-service model of healthcare, in most cases it’s an abstract concept as it’s still years away from being implemented by providers, with a few notable exceptions. But in a panel discussion at the Eye for Pharma conference this week, a medical and population health officer from a local provider pointed out that it will lead to more effective drugs being prescribed than under the current system.

Steve Linn is the CMO for Inspira Health Network and also serves as Population Health Officer for the New Jersey health system. He said the long-term benefits of a drug will be a priority in the decision to prescribe it over its immediate benefits.

“One consideration for a provider to use a drug will be, ‘Does it reduce the likelihood of readmissions down the road? If you can lower downstream costs and shorten the length of hospital stays” that’s critical.

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Stephen Bonner of Cancer Treatment Centers of America touched on the issue of building better drugs. “We are doing a lot of innovation at the cellular level to determine which interventions will be the most effective.” He noted that although a particular drug may not be approved for the particular type of cancer a patient has, that medication may be compatible on a cellular level. “It raises the question of how do you get around that regulatory hurdle? That’s something we’re working on.”

Still, the personalized medicine trend may make some of these decisions tougher to make, particularly for cancer. These treatments tend to be more expensive but are tailored to each patient and the genetic makeup of their tumors.

Linn will gradually expand his role as population health officer from being twice weekly to a full-time position. He is also looking forward to providers having better tools to deepen their understanding of their patient populations.

“It’s depressing how few practices know what percentage of their patients have hypertension,” he said. “Women of a certain age should be asked when they go to the doctor’s office if they’ve had a mammogram.”

He also pointed out that if doctors had an easy way to identify which patients would have difficulty paying for medication, they could direct them to programs to help cover those costs and improve the likelihood the medication would be picked up and taken, reducing the likelihood of readmission.

[Photo from flickr user My Eye Sees]