This is an exciting issue of HMPI, with features relating to drug and technology development, design of health plans and service payment models, and updates from the 2022 University of Miami health care conference.
Our lead article looks at the intersection of real-world evidence with our drug development and reimbursement paradigms. The authors argue how we can use data from clinical practice to make more informed decisions about emerging technology in the field of precision healthcare. Later in this issue, we return to drug discovery and development with a pair of papers looking at bench-to-bedside translation from the perspective of a scientist, as well as from the perspective of the institutional, business, and geographic ecosystem required to support translation.
Several articles examine the design of health plans and service payment models. The first examines the issue of whether and how patients can be informed consumers of healthcare services, a proposition underlying a lot of health plan designs. The second article is a timely look at staffing shortages, asking whether deskilling and top-of-the-license strategies can offer a solution. A provocative paper asks the question of whether auction theory can lead to better prices than the current administered pricing approach. And finally, the University of Miami healthcare conference brought together leaders to examine critical issues that are likely to be challenges in the coming year.
In the wake of the pandemic, national attention has moved from healthcare to other pressing national issues. However, underlying trends in the field are likely to change this dynamic. While consolidation is continuing across provider organizations, cost pressures and labor shortages will drive hospital to use their leverage in price negotiations with commercial health plans. The result will be a return to aggressive price increases in commercial health insurance premiums. Required price transparency on the part of hospitals and health plans will bring increased scrutiny to the private market with the release of health plan data this summer.
In the meantime, the growth of Medicare spending has slowed as a result of the impact of the COVID pandemic on life expectancy in the United States. CMS must make major decisions this coming year about the future of telemedicine and other technologies in the fee-for-service program, decisions that could shape the delivery system in profound ways.
Kevin Schulman, MD, MBA
Acting Editor in Chief, Health Management, Policy and Innovation (HMPI)
President, Business School Alliance for Health Management (BAHM)
Professor of Medicine, Stanford University