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AHIP: Rate How Well Treatments Work

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America’s Health Insurance Plans today unveiled a package of ideas for cutting U.S. health care costs.

AHIP, Washington, wants the nation to make more use of disease management, care coordination and prevention programs, and to replace the current medical malpractice system with a new dispute resolution process.

Providers and payers should handle just about all claims electronically, payers should shift to a “value-based” provider compensation system, and everyone should work together to find ways to introduce new medical technology, including new drugs and other new treatments, in a more cost-effective fashion, the group says.

“The AHIP proposal presents programs that are working now,” and it also “maps out how the public and private sectors can work together,” AHIP says in a statement.

If the nation implemented the entire package, the changes could cut costs by about $145 billion annually by 2015, AHIP says, citing an estimate from an outside firm.

The proposals for revamping the medical liability system and for establishing a process for comparing the effectiveness of various medical treatments face strong opposition, according to Ira Loss of Washington Analysis, Washington.

AHIP recommends giving providers, patients and others “access to a trusted source where they can find up-to-date and objective information on which health care services are most effective and provide the best value.”

Implementation of such a program is “not likely to happen anytime soon,” Loss says.

For one thing, “there have never been any studies done to compare various drugs that treat the same problem,” Loss says.

The Medicare Modernization Act of 2003 already calls for researchers to conduct comparative effectiveness studies, but the MMA provision has never been funded.

“The drug industry adamantly opposes this,” Loss says. “Their argument is that, ‘Drugs do not work on all people the same way, and the industry does not want anyone other than the doctor and the patient deciding what treatment should be authorized.’”


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