When there is substantial uncertainty about a new product’s expected value, stakeholders may have strong reasons to consider performance-based contracts. One of the hardest tasks in crafting such contracts is … Read More
Leaping Together Toward Sustainable, Patient‐Centered Innovation: The Value of a Multistakeholder Safe Haven for Accelerating System Change
Clinical Pharmacology & Therapeutics, November 2, 2018Gigi Hirsch Successfully delivering on the promise of emerging science in a world of value-driven healthcare requires that we fundamentally reengineer biomedical innovation processes … Read More
Designing financial solutions to ensure affordable access to cures
The reimbursement of emerging durable/potentially curative cell and gene therapies is likely to be a challenge for the US healthcare market. Considering the pricing of cell- and gene-based therapies approved … Read More
Stop-Loss Insurance or Reinsurance for Multiyear Contracts
In previous Research Briefs, we have discussed challenges faced by payers when contemplating using multiyear performance-based contracts. In this brief, we extend the discussion to include additional difficulties that may … Read More
Impact of Patient Mobility on Annuity/Performance-Based Contracting
Spreading payments over time for durable or curative therapies can provide a better alignment between benefits and costs, but creates challenges when patients switch insurance coverage during the contract term. … Read More
Orphan Reinsurer Benefit Managers (ORBMs)
An Orphan Reinsurer Benefit Manager (ORBM) could address the financial challenges (payment timing, therapeutic performance risk, actuarial risk), created by durable/potentially curable gene and cell therapies especially for smaller insurers … Read More
Impact of Actuarial Risk on Health Plans
The uncertain number of patients likely to be treated with an expensive novel therapy (actuarial risk) could represent a major financial issue for some payers. In this brief, we will … Read More
Designing Precision Financing for Cures
Designing Precision Financing for cures can be informed by a framework that tailors solutions to the three financing challenges of actuarial risk, performance risk and payment timing based on the … Read More
The heterogeneity of health care payers suggests that durable therapies need precision financing targeted to each payer segment
FoCUS participants have identified four payer segments for precision financing: self-insured employers and related organizations; health insurance plans and managed care organizations; Medicare; and Medicaid. Download FoCUS Research Brief_2018F202-014Share the … Read More
Leveraging Industry-Academia Collaborations in Adaptive Biomedical Innovation
Clinical Pharmacology & Therapeutics, December 1, 2016R. Stewart, P. W. Barone, A. Bellisario, C. L. Cooney, P. A. Sharp, A. J. Sinskey, S. Natesan, and S. L. Springs Despite the … Read More