payers

This blog is part 9 of a series on the MEAT value-based procurement project, an initiative that advocates towards a shift from price-based procurement towards value-based procurement. It does so by defining a Most Economically Advantageous Tendering (MEAT) framework that includes the value of medical technologies, services and solutions in procurement processes across Europe. Read part 1 , part 2 , part 3 , part 4 , part 5 , part 6 , part 7 and part 8 . Health systems across the globe are faced with unprecedented challenges. Demand and patient expectations are rising while financial resources are diminishing. To respond to these trends, we need a new approach to how we manage healthcare. At NHS North West Procurement Development, we have been looking at how rethinking procurement can deliver better outcomes for patients, increased savings opportunities, and wider operational efficiencies. We began exploring the principles and practices of ‘Value Based Procurement’ (VBP) in 2014. By working with the University of Liverpool and engaging with a wide range of stakeholders – including ICHOM, legal experts, suppliers and MedTech Europe – we have studied how VBP can work in practice and the changes needed to make it commonplace. New framework for change To move this process to the next stage, we have published a 30-page guide setting out the rational for embracing VBP, providing a framework for delivering change, and setting our vision for the future. We want this to inform the work of procurement officials and suppliers alike, to inspire health professionals, patients, policymakers and others to change how they think about preparing our health system for the future. Hospitals are busy places and there is rarely time to take a breath and consider reforming the system. That’s why we have aimed to make the new guide clear, concise...
As ‘thinking season’ kicks off, the focus is on how technology and big data can deliver better value healthcare to more people than ever before. January is a time for reflection, planning and predicting what lies ahead. It’s the season for assessing the mega-trends that will shape our future and working out how we will respond. Perhaps the most prestigious venue for future-gazing is Davos where world leaders from politics and business gather on 17-20 January for the World Economic Forum . Here, global influencers will look at how prevailing economic, social and political forces present challenges and opportunities for all of us. Last year, the key phrase from Davos was the ‘ 4 th Industrial Revolution’ . The WEF set the tone for thousands of conversations on the topic last year, including at the MedTech Forum in Brussels last December. This year – with the convergence of technologies that blur the lines between the physical, digital and biological systems still very much in view – the theme will be Responsive and Responsible Leadership . But what can healthcare leaders expect from 2017? When it comes to healthcare , the WEF frames the conversation with some key demographic statistics: - By 2050, the world’s population will have risen to 9.7 billion - 2 billion people will be over the age of 60 To continue to meet the (growing) demands of healthcare consumers without blowing up healthcare budgets, new ways of delivery services will be required. Smarter, more efficient, technologies and systems will be essential. This brings us to the concept at the heart of many new-year health policy forecasts: value . Value-based healthcare has been something of a buzzword since it was coined by Harvard’s Michael Porter . Most of us have an intuitive sense of value. In healthcare, Porter...
I'm greatly looking forward to the European MedTech Forum meeting in Brussels in December, where I’ll be talking at the plenary about payers and hospitals aligning expectations and sharing values. I'll also be taking part in a panel session on personalised and precision technologies. NICE is ideally placed to help the medical technology and diagnostics industries to meet increasingly challenging expectations in resource-constrained health systems. Through our Medical Technologies Evaluation and Diagnostics Assessment Programmes we produce evidence-based guidance and advice on innovative medical and diagnostic technologies for the National Health Service (NHS) in England, recommending those that are clinically and cost-effective. Payers are often most uncertain about the value of a new technology at the point where an adoption decision is needed for the whole health system. NICE is able to help in these situations by targeting further evidence development on the specific uncertainties remaining about the use of the product once we have done our evaluation. We work with academic evidence assessors to produce a protocol which the company can then use to target their research on those uncertain outcomes, enabling us to update our guidance at a future point. Of course, we would prefer companies to undergo a NICE evaluation with the correct evidence already in place, so we also offer a Scientific Advice service to companies as they plan their trials. The cost of developing evidence is a major concern to companies facing short patent lives, “fast-followers” and frequent device iterations. NICE is involved in a work stream of EUnetHTA Joint Action 3 that seeks to create a quality tool for registers being used to collect health outcome data. The aim is to give guidance to register developers (including companies) and those using the data for HTA, a common set of standards so that companies don’t waste...
This blog is part 7 of a series on MEAT Value-Based Procurement, an initiative that advocates a shift from price-based procurement towards value-based procurement in healthcare. It does so by defining a Best Price Quality Ratio method within the Most Economically Advantageous Tendering (MEAT) framework put forward in the European Public Procurement directive. Read part 1 , part 2 , part 3 , part 4 and part 5 and part 6 . Our health systems need reforms to maintain universal health coverage and, given the economic and demographic pressures we face, Europe cannot afford its citizens to be in poor health. This will require new thinking about the economic value of health for individuals, families and society (health as an economic good) in addition to the economics (the cost-efficiency) of healthcare systems. Instead of focusing on the costs of healthcare, we must consider what is delivered. The full value of investing in health and quality healthcare can be realised by focussing on health outcomes complemented and enhanced by the economic value offered by being in good health and having cost-efficient health systems. This value-oriented approach can be implemented when purchasing health technologies. It is already seen in some modern procurement procedures resulting in the highest economic value in addition to best health outcomes. These most economically-advantageous tenders (MEAT) can deliver optimal value to society. To make informed decisions about what constitutes value, we need to consider the full value that health investments bring – not just the outcomes for patients or for hospitals, but the full impact these interventions can bring to society by keeping people in good health. Defining value The real economic consequences of being in a state of ill-health are not solely related to the direct costs of health and care, but include wider socio-economic consequences and...
This blog is part 6 of a series on the MEAT value-based procurement project, an initiative that advocates towards a shift from price-based procurement towards value-based procurement. It does so by defining a Most Economically Advantageous Tendering (MEAT) framework that includes the value of medical technologies, services and solutions in procurement processes across Europe. Read part 1 , part 2 , part 3 , part 4 and part 5 . When the new EU Directive on public procurement was finalised in 2014, replacing the previous framework, it was hailed by the European Parliament as a tool for ensuring better quality of supplies and services and value for money. The European Parliament was also keen to emphasise how the Directive was designed to encourage innovation, improve SMEs’ access to public sector markets and to integrate environmental and social considerations into procurement policy. One of the tools within the Directive to achieve these aims was the requirement for contracting authorities to base the award of contracts on the most economically advantageous tender (MEAT). Contracting authorities were also permitted to use lifecycle costing in their award criteria in order to assess total costs. Previously, tenders could be awarded either on the basis of lowest price, or on MEAT criteria which typically included a balance of price and quality criteria. All of this seemed to be good news for those of us with an interest in value-based healthcare. Defining what MEAT really means However, whilst the terminology was promising, it was misleading. Indeed the Directive provided that MEAT could be based either on price only, cost only, or best price quality ratio. Although Member States have been given a choice when implementing the Directive into national law whether they wanted to exclude or restrict the use of price or cost only as the sole...
Global healthcare systems confound consumers and clinicians alike and cost more each year. Overall, we spend nearly US$10 trillion globally on healthcare with a wide disparity of access and outcomes. Chronic health conditions are increasing in incidence and prevalence in developed and emerging markets, further taxing clinicians, payers and hospitals. To serve growing populations of consumers demanding quality care that demonstrates clear clinical and economic value, access to and the provision of primary care needs to expand, enabled by technology and supported by non-physicians with a focus on prevention. “We need to flip the system on its head,” said Nancy Gagliano, MD, senior vice president at CVS Health and chief medical officer of CVS/minuteclinic. Rather than playing its historic role as gatekeeper to a scattered array of specialties, primary care will become the nexus, providing simplicity, value and better health outcomes. That will mean taking risks and challenging old assumptions. The global assumptions of looming physician and nurse shortages are based on outdated care delivery models. In the New Health Economy, with the emphasis on giving purchasers greater value for their healthcare dollar, do-it-yourself consumers and integrated care teams armed with a black bag of virtual tools are poised to reinvent primary care and close the gap. Traditional healthcare players will need to partner with New Entrants to adapt to a vastly changing healthcare market and achieve global objectives of lower costs, better outcomes and access points that meet consumer demands. With over US$3 trillion spent annually on healthcare, the U.S. market is at the forefront of the transformation of primary care. But, market incumbents remain susceptible to new entrants who identify and commercialize more flexible, lower cost, preventive care solutions in emerging markets. To understand how the New Health Economy will force changes in the provision of primary care,...