Salon Recap: Shift to Fee-for-Value and Impact on Medical Devices
In April, MATTER assembled a diverse group of stakeholders for a salon on how healthcare payment and delivery reforms are impacting the way health systems evaluate medical devices. The group included executives from device manufacturers including Abbott Ventures, Hill-Rom, Briteseed, and Diagnostic Photonics; providers, payers, technology and telehealth experts, and contract and procurement specialists. We had a spirited conversation about how health systems and manufacturers are interacting in this brave, new, fee-for-value world. Following are a few high-level takeaways from the morning.
New Customers are Influencing Purchasing Decisions
Providers continue to consolidate both horizontally and vertically as health systems combine and purchase physician groups. This consolidation allows providers to enter into at-risk financial arrangements to manage the costs of caring for a population of patients. However, under these new care models, an individual physician’s influence over the medical device purchasing process is decreasing, causing health systems to involve multiple stakeholders – often called “value committees” – in the evaluation and purchase of new technologies. These new customers have unique incentives and priorities that medical device manufacturers need to be aware of.
Long-term Value is Increasingly Important to Payers and Providers
Both payers and providers want to understand the long-term value of a medical device, including its impact on cost, quality, and outcomes. Providers in at-risk financial arrangements are particularly focused on its impact on downstream medical costs (e.g., post-acute care use and setting). Some of the earliest examples of this trend can be found in orthopedics, where commercial and government programs such as Medicare’s Bundled Payment for Care Improvement initiative consolidate payments for acute and post-acute care services for joint replacement procedures.
Data and Analytics are Becoming Critical to Proving Value
Many manufacturers are already moving in the direction of collecting and analyzing medical device data and providing more connected and interoperable devices. To be more competitive in the future, however, manufacturers will need to understand what specific kinds of evidence payers and providers need to prove a device’s value under these new payment models – such as case studies and real-world examples – instead of just randomized clinical trials.
For those interested in more details about what was discussed at the salon, meeting notes prepared by Navigant Consulting can be found here. And if you a hospital administrator or medical device innovator interested in being part of this important dialogue in the future, please contact Shareef Ghanem (firstname.lastname@example.org), senior program manager, for information on upcoming events.