by Leslie Small
Five major Blues affiliates — Blue Cross Blue Shield of
Massachusetts, Blue Cross Blue Shield of Michigan, Blue Shield of California,
Highmark Inc. and Independence Blue Cross — on June 22 launched a startup company, Evio, that aims to "offer
innovative medication solutions to patients, providers and customers."
Evio's three chief goals:
- Continuing "the evolution toward value-based care
and enhancing outcomes-based contracting in the pharmacy space, especially
on high-cost drugs,"
- "Using evidence and data from real patient
experiences to ensure the right medication gets to every patient, where,
when and how they need it," and
- "Developing new, and enhancing existing,
partnerships that leverage the innovation happening in the pharmacy and broader
healthcare, technology, and analytics sectors today — to improve
affordability, outcomes, and experience for patients."
Experts' views:
- "Value-based reimbursements for drugs provide a
great opportunity to reduce costs," says Brian Anderson, a principal
with Milliman, Inc. However, "these approaches are challenging to set
up, monitor and report on. The goal needs to be to eliminate waste in the
system and overprescribing. Once these areas are addressed, the key is to
incentivize value-based payments for outcomes and care management."
- "Part of me says that this is an attempt by the
Blue Cross folks to standardize some kind of value-based purchasing
arrangement in a way that would work over multiple plans, which probably
would make it more effective," says Jeff Myers, senior vice president
of market access and reimbursement strategies with Catalyst Healthcare
Consulting, Inc.
Blues plans' dedication to lower drug costs:
- The Blue Cross Blue Shield Association and 18 Blues
affiliates — including the most recent addition, Anthem, Inc. — have joined
Civica Rx, a not-for-profit organization founded by health systems that
works to address shortages and price hikes for generic medicines.
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