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Financing models overview for patients
This short document provides a summary of the FoCUS Project consortium’s work to develop cross-stakeholder solutions to the challenge of financing durable / potentially curative therapies. This document focuses on solutions that address performance and payment risk.
Solution Prioritization Tool
The stakeholders with whom we have worked requested a simple tool to help identify preferred financing solutions for different situations based on the experiences of FoCUS members and pilots.
The Solution Prioritization Tool asks a short set of questions about the types of risks you want to manage, your plan characteristics and the types of therapies you are evaluating. The Tool then suggests high-potential precision financing solutions based on the experiences of FoCUS pilots. The Tool will also point you to other solution design elements to consider in building a full solution for providing patient access to these therapies.
You may follow hyperlinks in the priority financing solutions to read descriptions of each solution. The descriptions explain why that solution was suggested and highlight any unique elements for different payer types or situations. The same content may be accessed here.
This analysis is intended to support a strategic assessment of each therapy and help users quickly benefit from FoCUS insights to date. Users are ultimately responsible for their own assumptions and analysis.
Guided Assessment Worksheets
These companion worksheets can assist you in understanding the implications for your organization and potential solutions.
Payer assessment: Individual indication
For more information about this topic visit Guided Assessments, Payer Assessment: Individual Indication
Download the Individual Indication Worksheet (xlsx)
Payer assessment: Pipeline
For more information about this topic visit Guided Assessments, Payer Assessment: Pipeline
Download the Pipeline Worksheet (xlsx)
Supplier Evaluation Template
Market solutions for supporting gene and cell therapy financing and access vary in their design. You should clearly understand and articulate your goals prior to assessing solution partners. To help you navigate through the details and logistics, we've put together a list of questions to consider asking in any supplier assessment.
Medicaid Milestone-based contract tool
A toolkit to assist State Medicaid organizations in designing, negotiating and establishing milestone-based contracts has been developed, building on experiences of State Medicaid leaders.