Pay-For-Performance Medicine


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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.

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Doctor Compensation

Insurers Anthem Inc (NYSE: ANTM) and Humana Inc (NYSE: HUM) have been leading the charge for a new way to compensate medical professionals by focusing more on the quality of their care rather than the quantity.

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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

Pharmaceutical companies are also seeing a shift toward value-based cost models; Express Scripts Holding Company (NASDAQ: ESRX) has been working to secure a similar results-based pricing model with pharmaceutical companies.

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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New research shows the biggest crypto buyers are back. And this time? They could hold for the possibility that Bitcoin will surpass $100,000 in 2024. You don’t want to miss the next massive crypto bull run like we saw in 2020 and 2021. To know exactly what’s going on and what to buy… Get Access To Benzinga’s Best Crypto Research and Investments For Only $1.


Posted In: Health CareTop StoriesGeneralInsurancepreventative careSteve Miller