New Managed Care Findings Has Been Reported by Investigators at University of Washington (Performance-based Risk-sharing Arrangements for Devices and Diagnostics In the United States: a Systematic Review): Managed Care

2022 JAN 28 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Data detailed on Managed Care have been presented. According to news originating from Seattle, Washington, by NewsRx correspondents, research stated, “Performance-based risk-sharing arrangements (PBRSAs) have continued to emerge and evolve over the last 2 decades. To date, most of the attention and available literature have focused on pharmaceuticals.”

Our news journalists obtained a quote from the research from the University of Washington, “To assess the current status and trends regarding the use of PBRSAs for diagnostics and devices in the United States. We reviewed publicly available PBRSAs for diagnostics and devices using the University of Washington Performance Based Risk Sharing Database. We augmented the review using PubMed, Google, and payer and industry websites. Key words and phrases such as outcomes-based, value-based, coverage with evidence development, performance-based, and risk-sharing were used in combination with device or diagnostic. To characterize arrangements in terms of product and market attributes, we extracted data for each product, including arrangement descriptions, arrangement type, year, therapeutic area, product manufacturer, payer, and product type. Arrangements were analyzed using descriptive statistics. Fifty-two arrangements were identified between the years 2001 and 2019, with 30 (57.7%) for devices and 22 (42.3%) for diagnostic tests. Among these, 23 (44.2%) were coverage with evidence development (CED), only in research; 17 (32.7%) were performance-linked reimbursement (PLR); and 12 (23.1%) were CED, only with research. The majority of arrangements for devices were developed in cardiology (12, 40%), endocrinology (4, 13.3%), and radiology (3, 10%). Most of arrangements for identified diagnostic tests were in oncology (17, 77.3%). Over time, there has been a trend towards increasing adoption of PLR and CED, only with research, especially since 2014. This is the first study to comprehensively review PBRSA arrangements for diagnostics and devices in the United States. Our findings demonstrated that there is substantial PBRSA activity for devices and diagnostics, and the pace of PBRSA adoption appears to be increasing in terms of frequency and variety.”

According to the news editors, the research concluded: “These arrangements have implications for managed care into the future as the health care system shifts towards value-based care and value-based pricing to contain cost for payers and ensure value in the patient populations.”

This research has been peer-reviewed.

For more information on this research see: Performance-based Risk-sharing Arrangements for Devices and Diagnostics In the United States: a Systematic Review. Journal of Managed Care & Specialty Pharmacy, 2022;28(1):78-83. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

The news correspondents report that additional information may be obtained from Josh J. Carlson, University of Washington, School of Pharmacy, Choice Inst, Seattle, WA 98195, United States.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.18553/jmcp.2022.28.1.78. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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