Rising U.S. healthcare costs have spawned major reforms designed to maintain the quality of care while reducing the burden on patients.
Recently, a new initiative to rework the cost of medical care in order to reward quality over quantity has shaken up the industry as more companies call for a cost model based on performance.
Doctor Compensation
Instead of paying for each individual test as in the traditional model, Anthem and Humana have created new payment schemes that reward providers for their patients' outcomes. Not only does this model eliminate a barrage of unnecessary tests, but it puts the focus on preventative care and is expected to greatly improve public health as a whole.
Medications
As cancer drugs can sometime cost over $100,000 per patient, Express Scripts is hoping to cut that price down by allowing patients to pay less for drugs that don't have the desired effect. While the deal hasn't been negotiated yet, Express Scripts Chief Medical Officer Steve Miller said the company is in talks with cancer drug manufacturers to work out a new pricing model based on how successful each treatment is for specific types of tumors.
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