Jennifer Colamonico
Welcome to HMA Vital Viewpoints on Healthcare. Concise conversations with experts that identify practical solutions to make health care and human services work better. I'm your host, Jennifer Cole Monaco, and I'm thrilled to be your guide as we explore new ideas for solving challenges that confound our uniquely American systems charged with delivering health and health care. Kevin Kirby has more than 25 years of experience with Medicare reimbursement and extensive Medicare Part B expertise, particularly relating to pharmaceuticals and biotechnology.
Kevin joined the Moran Company, which is now an HMO company. After serving as legislative counsel at Pharmacia and Upjohn I, Kevin was active in policy development for clients interested in issues that were affected by the Affordable Care Act, and he has become an expert in a variety of drug reimbursement issues governed by the Medicare Modernization Act. Kevin, thank you for being with us on the podcast today.
Let's just start how did you get started in the pharmaceutical industry? How did you end up there?
Kevin Kirby
It's interesting. My first job as a high schooler really was in a pharmacy. So I started in retail, went into some policy issues doing a volunteer program after college, but it was also working for a pharmaceutical lobbying office as a college internship. So it's really been my whole career has had some tie to pharmacy or for pharmaceutical issues.
That's kind of continued for more than 25 years, as you said. Right. We want to ask people to do the math.
Jennifer Colamonico
So, what part of the policy analysis, part of this sort of grabbed you?
Kevin Kirby
What I found early on in my career was that a lot goes into figuring out what the laws governing our health care system need to be, and that those policy development issues can take years. So I started my career right around the time of the Clinton health care reform that generated some of the ideas that then later became part of the Affordable Care Act, but did a lot of work for multiple years on drug coverage issues because there didn't used to be a drug benefit in Medicare.
And so we were working on, you know, what would a drug benefit look like? And from the perspective of a lot of my clients, it was really important that there be some catastrophic coverage to protect people against high drug costs. And so that was something that both in the pharmaceutical company that I worked for in the mid 90s, and then sort of starting out at the Moran company was a focal point for our clients, and we did a lot of the development that that led to Medicare's drug benefit, including that catastrophic coverage, which finally is converting to a full stop loss or full cap this year.
Jennifer Colamonico
Right? Which is interesting. We've gone quickly from not covering it all to covering it substantially, which then of course raises questions. And we always have questions about sustainability of Medicare and Social Security. It's especially it's kind of a, you know, an ongoing concern. But as you've watched Medicare policy evolve in this space, what types of changes have had the most significant impact on the sustainability?
And maybe I'll say kind of positively and negatively, right. Because there's certainly both.
Kevin Kirby
Yeah. I might be a little contrarian here because in some sense, people younger than me would express surprise that Medicare didn't always cover drugs. That it seems to me it's a fundamental part of health coverage is to be able to get access to prescription drugs. And I think that the way DMs and Congress administered the program is they were careful stewards trying to make sure that it was affordable.
So it was a big change in Medicare at the time. But it's taken many years for the premiums that people pay to catch up to the Congressional Budget Office is original. Estimates, and it feels to me that what's driving a lot of the questions around sustainability for Medicare in particular is demographics. We just have a lot more senior citizens right than we used to.
There are real questions about how we're going to make sure to keep the promise of Medicare going. But it doesn't feel to me like adding a drug benefit or, you know, something that somebody did has created this problem. You could argue people needed to step in sooner to address some of the demographic issues and some of the things that are driving the growth.
But it feels to me like there is still time to do that.
Jennifer Colamonico
So, as you've seen the Affordable Care Act and the Medicare Modernization Act, sort of, you know, the implemented how do you think that these laws have really shaped the landscape for reimbursement? And, and, you know, what are companies kind of challenged with today as, as these laws continue to evolve.
Kevin Kirby
As we've discussed, the MMA kind of created Medicare coverage for outpatient drugs, it also made some reimbursement changes for a physician, administer drugs to try to use the average sales price to kind of bring some of those costs down. And there have been questions people have raised about is that still the right metric? And, and what can be done to, to control those costs?
And I think we're going to continue to see that evolve over time. But it does feel to me like having the Affordable Care Act to take a government control of more of the health care systems. So that they're more people that now are getting their drug coverage through government plans, whether it's Medicare or the exchanges. It has created more of a spotlight for the pharmaceutical industry on drug pricing issues that finally led to the Inflation Reduction Act, tried to make some changes.
And I think we'll continue to see the landscape evolve, just as people try to make sure that we can continue to realize the value for drugs in an affordable way.
Jennifer Colamonico
Right. Well that's great. That's exactly what I was going to go next to. So that's all evolved. And now we have this the Inflation Reduction Act, as you mentioned, which you know, in common parlance is Medicare gets to negotiate the price of drugs, a broad bumper sticker version. Right? Obviously, it's more nuanced than that. So you know it's a big deal in some ways.
And it seems like maybe a little bit overblown in other ways. So how do you explain this to people in a kind of a short, understandable way to really understand the magnitude of what the inflation Reduction Act did for price negotiations?
Kevin Kirby
So I think and perhaps I've been working for the pharmaceutical industry for too long, but calling them negotiations at this point, I think the industry has a point that they're not really that the Congressional Budget Office for years, when faced with policies that would allow for negotiation, said, well, no, the part D plans are going to do better.
You're not going to get savings from that. And what led CBO to first start giving savings to some of these negotiation policies was the presence of an excise tax and the presence of a government ceiling price. These are that start right now price controls. The question to your point of whether this is a big deal or not is going to depend on how this evolves over time and how people look at some of the consequences, unintended or intended, of the IRA, and decide where they take this next.
So is that a question of putting more drugs through the negotiation process in quotes? Is it moving to some kind of reference price or, you know, launch price control similar to the Trump administration's most favored nation, policies that, you know, may or may not go forward in the future, but it's those sorts of policies that CBO has said have more of an impact than just expanding the IRA as it is.
So I think it's going to be interesting to watch, obviously, when you have just ten drugs now coming out of the gate, and some of the savings from those negotiations are difficult to quantify because they're capturing some of the discounts already in the market, and those manufacturers are exempt from some of the required discounts that they were going to be required to provide under the reformed drug benefit.
Otherwise, I'm probably not included in some of those estimates. So it's still to be determined exactly what the impact of the act is going to be. But it does seem to be bringing drug prices down for the first ten drugs. And then we'll see how it evolves.
Jennifer Colamonico
So a couple questions. And what you just said first of all, so the first ten drugs I might be mistaken, but those are drugs that have been around for a while. Are there do they have generic alternatives or maybe on the precipice of biosimilars? Some of that.
Kevin Kirby
Yeah. So to be picked you can't have generic or biosimilar competition yet. But you also have to have been on the market for some number of years. There was kind of at least nine years before negotiations starts for small molecule drugs and 11 years for some of the biotech products. And that was really the way it was designed, was to get at those products where maybe competition hasn't started yet.
But Congress felt like it should. So you try to capture those products that are sort of have been on the market long enough that policymakers would argue that they've captured the value of their research and development investment, but haven't yet gotten generic or biosimilar competition.
Jennifer Colamonico
So it's honed in on that. So they've had their chance to, you know, reasonable amount of years, nine, 11 years, that's, you know, reasonable amount of years to.
Kevin Kirby
Depending on your point of view, depending.
Jennifer Colamonico
On your point of view. Right. That would be my point of view. Reason not I won't put words in your mouth. So a certain set period of time to, to capture and then but you know, before generic competition comes in, okay. That's a interesting nuance. So, and then can you talk more about your point about how CBO views things like, most Favored Nation, you mentioned that they view that as perhaps more beneficial in terms of saving money.
Can you talk a little bit about kind of the different mechanism that that would have brought into drug pricing?
Kevin Kirby
So what I was referring to is they put out a report recently talking about their opinion on different ways that drug pricing policies might evolve over the next few years, and what they said was that just expanding the IRA would have a pretty small impact in, you know, sort of the the one percentage point, you know, and obviously when you're talking about billions of dollars of drug spending, that's that's not nothing.
But they said that using reference prices, you know, whether it's an international price or, or something else to set the pricing different from what's happening under the IRA is negotiation could have a more than 5% change in drug prices. And so I think the idea is probably both what the metric is probably is sort of the universe of products that we, you know, is it going to be a launch price thing that you're going to tie prices in the United States to other countries or something like that?
So there are a lot of different ways where that could potentially bring prices down. CBO also noted that some of those things are going to have impacts on other countries impact on research and development. So there are, you know, there's not a magic wand that you can wave that is just going to magically cut drug prices without other consequences.
Jennifer Colamonico
Well, that cuts to my punch line, which I'm not going to get to yet, but I'm going to ask you about a magic wand later. So think more about that. But let me just ask, you know, just even this conversation, obviously there's you can already tell there's misinformation perhaps, or perceptions that differ on, you know, what's going to work.
So based on your years of research and experience here, what do you think people get most wrong about pharma pricing and the value, accrued by pharma products?
Kevin Kirby
So I think a lot of the complex ity of how people think about pharma pricing comes with the fact that people feel differently about health care. They're not evaluating the price that they pay for health care in the same way that, you know, they evaluate the price they pay for their phone or their car. And and there are things that the pharmaceutical industry does to bring doors to market, you know, that their HIV is now probably a chronic illness in ways that it really wasn't, when I first came into health policy, a couple of my clients have are getting close to having that their, their drugs to treat cancer be found to be
curative. And so that's really exciting. That costs money that, that the research and development that goes into that takes a, a lot to fund and a lot to do. And so the question really is, do we want to allow people to set prices to encourage more of those investments and innovations? Or is there some way we're going to treat drugs differently than other products?
And you can argue from a policy perspective that there are reasons that perhaps that should happen. But the consequences are also there, as CBO and others have recognized, that you're going to get less drugs if prices are cut too far. And some stakeholders would argue that CBO has underestimated what will happen as a result of IRA negotiations. But they see an impact.
The industry certainly sees an impact. So from my perspective, a lot of that is to be determined. But I think there's a need for care when approaching how you're asking an industry to set its prices. And then what happens to investment in that industry as a result?
Jennifer Colamonico
I want to ask you more about CBO in just a minute. But, let me just go back to, you know, your point about drugs have been treated differently, right, than the rest of health care. From the get go, they weren't included then. They were included. But it's and, you know, yes, there's a more transaction panel piece to it because we pay separately at the pharmacy versus, you know, I mean, I guess we somewhat pay for a lab or, or an x ray or, you know, and, and all of those incentives are like the levers that we use to try to, you know, direct people to making good health care decisions or etc..
Right? So if pharmaceuticals are have been treated differently in terms of, you know, that they were not included now that they are included, does it make sense to keep them sort of still on the outside of what we pay for health care? I mean, there are when we think about, you know, some value based payment and other, types of payment reforms.
I think there's always the question, are they inside or outside of the bundle? You know, do you think that it it makes sense to keep pharmaceuticals on the outside of payment, mechanisms or, does it makes more sense increasing to roll them in to all the other interventions that might generate a health outcome?
Kevin Kirby
It's a really interesting question. And I think one of the areas where you can see that happen somewhat is in Medicare's inpatient prospective payment system, where there drugs that patients need when they're being hospitalized. And one of the problems that happens is if you have a drug that is particularly low volume and also is high cost, it creates an access barrier.
When a hospital says, well, I'm only going to get paid a certain amount for this payment bundle. And it's not worth it to me to, to pay for this drug. And then, you know, whatever volume of cases that use that drug is it large enough to influence the payment for the diagnosis related group, which is the bundle that Medicare uses?
So the more that you create those kinds of bundles, you're right. You can create incentives for physicians, hospitals, other providers to use, you know, the most cost effective alternatives, but you're also going to create barriers to access. And so the question is what's the right balance in that situation? And I think it's an important part of policy development.
And there's a lot going on.
Jennifer Colamonico
I feel like that that right there contributes to a lot of the confusion. And probably that's the punchline of all this is it's complicated. Right. But makes it complicated because we, I feel like we constantly cycle between everyone should get access who needs access. Right. And that becomes kind of a rallying cries, particularly for patient groups, you know, perhaps rightly so.
But then no one should have to pay of over a certain amount because it affects people financially. Right? So it's like we're kind of caught in this conundrum, price and access. Right. Being the, I guess, textbook, probably a chart that you can draw in graduate school. Right. Like, you know, there's a line there somewhere and not everybody gets everything for a low price.
So maybe let me kind of go back to the CBO analysis. And, the Moran company became somewhat famous for replicating CBO analyzes, around how particular policies are judged to either save or cost money. CBO was a big deal. I think, I didn't fully appreciate how much CBO is a big deal in determining legislation and what moves forward in Congress.
So, can you just talk a little bit about, like, the impact of that model, I guess, and then, you know, in your experience here, you know, where does it over or underestimate, you know, you know, given its importance, obviously, it's it's an estimate, it's a model. So maybe, share a little bit of your insights around the impact of that model and how it's working.
Kevin Kirby
Well, so one of the things that the founder of the Moran Company always said was that the secret to successful forecasting was to forecast often. And so in working around CBO issues over the years, we've been really humble about our ability to get it right. And we understand that the pressures that they're under, they can't operate like university research think tank.
There's not enough time to get everything done and be fully careful. So what they're trying to do is give Congress the best estimate they can of what the impact of particular policies is going to be, because they're decisions you have to make between what you want to pay for one thing versus another and and how we structure ourselves.
There also are really complicated responses to pieces of legislation that can change, what the impact is. I mentioned earlier that premiums in part D haven't really hit the points that CBO thought they were going to hit. Part of that is because of the response that the plans made, that instead of taking manufacturer rebates and reducing the cost that people pay at the point of sale, they took all of those rebates, or most of them, and apply them to the premiums that they were charging to their beneficiaries, so they were able to compete by keeping premiums down.
Can you say, well, CBO got that wrong or was that just that the market evolved differently and that there was a reasonable chance that somebody could have gotten out of the gates competing on the price at the pharmacy counter, and then things would have been different. So there are always those sorts of decisions that you make a reasonable choice, but then, you know, that ends up being wrong, then your forecast is going to be wrong.
And I don't know that there's a way to get around that. So I think it's just a question of trying a CBO does to continually improve what they're doing and, and get things right. And, and I do think they get it right more often than not.
Jennifer Colamonico
Maybe circle back to this, issue of, you know, pharmaceuticals, you know, can sometimes save costs elsewhere in the system. Right? That's sort of a promise. You, you're you slow down the progression of a disease early on. It saves money in the long run. Or perhaps it offsets other types of care that might be needed if you weren't taking, the medication.
It seems like the data on that front haven't been strong. And maybe I'm wrong about that. Correct me if I'm wrong, but I'm curious your thoughts about, you know, where do you see evidence being amassed around, that sort of cost savings trade off? And, you know, maybe why it hasn't, is it that we're not able to collect the data or is the data haven't sort of proven their point?
Thoughts on kind of measuring the cost savings trade off of pharmaceuticals.
Kevin Kirby
You're right that the data that those arguments have been made for many years and for many years, CBO wasn't willing to recognize them at all. In the last several years, they have started to allow some offsets for policies that improve prescription drug adherence on the theory that they were convinced that there was evidence that brought these things down.
But it's not a dollar for dollar thing at all, and it's just an assumption. So it really depends on the spending in other areas for particular types of patients and then how much adherence you're able to draw there. You've seen with the obesity drugs that CBO, you know, see some credit for some of the things that are happening to other health care spending.
But it's still the drugs themselves are going to outweigh some of those offsets. Some of it is a data question, and some of it is, you know, that there can be real benefits, you know, and there's also even a darker element, because if you have a drug that cures cancer, you've got people living longer and spending money on other parts of Medicare.
You know, it's out there. If it is while somebody is young, it keeps them in the workforce. And, you know, the other positive benefits to the budget that happen there. I don't think anybody would argue that we don't want that cure for cancer, but, you know, it is going to continue to cost money.
Jennifer Colamonico
Yeah. That is that is kind of the dark, but important, underbelly of some of this analysis. You mentioned the obesity drugs. I guess if you think about it just as, as a averagely, informed person. Right. If you can take medications earlier in your life to avoid obesity, you avoid downstream negative effects of obesity, right?
Anything that's preventing something or capturing, you know, reducing the impact of a disease early on is going to have downstream, effects. But how does that work with, you know, CBO's estimating Medicare costs. Obviously, don't get into Medicare until you're 65. So you take a drug when you're 40. Somebody else is paying for that, right? Medicare is not paying for that.
So, you know, when they assess the impact of GLP ones for just as an example, right now, are they only looking at the expected cost savings of, you know, to Medicare or are they kind of modeling the overall cost, given that somebody has to be paying for those right now? You know, how does that factor into their estimates around those drugs in particular?
Kevin Kirby
So they're modeling against a baseline of what otherwise is happening in the system. So a policy that expands coverage in Medicare isn't going to get credit for the, you know, savings when somebody is younger, unless it's making changes to to encourage more use of, of a product when some of these younger. But how the score turns out really does depend on what the policy is.
So CBO has said that something that just takes obesity drugs and covers them in Medicare could end up costing $35 billion. At the same time, we've heard reports that more limited portions of the of limited versions of the policy that, say, would provide coverage for people that already had it when they were younger, before they came to Medicare, would be far more limited.
So some of those trade offs are, are there? Because to your point, if you're fully realizing the benefit of the products by continuing them for patients that were already taking them when they're younger, maybe you're getting, you know, more of the benefits for the Medicare program to to keep that going forward.
Jennifer Colamonico
Are they estimating? I mean, most of that's happening in commercial coverage, right? I mean, I'm, I'm sure some Medicaid, but, is there a place where they're estimating the overall impact, or is that coming more out of universities and research, you know, academic think tanks?
Kevin Kirby
So CBO tends to be focused on what they're being asked to score. So they may have some background research that they're doing on the overall benefits, to be ready to consider things that might require employers to cover it because, you know, are things that flow into the tax revenues and ACA subsidies and that kind of thing, so that there are impacts on the federal budget or policies that require coverage.
But some of the benefits of the products, you know, being taken now under current law would just be considered part of CBO's baseline. And so then when they score a policy, it's a question of what are we changing relative to what's in the baseline.
Jennifer Colamonico
So we're not necessarily looking to CBO for some of those macro I mean, you know, if it's a piece of legislation that has been submitted, it's in their domain. They'll score it. But there are other and presumably other places that are looking maybe at more, macro impacts.
Kevin Kirby
Yeah, I think that that's right. I think CBO certainly has research and reporting that it uses to inform its score is on the on the macro benefits. And some of that, you know, is part of the papers that they've, they've put out. But I think you're right that, you know, what other research is that if you're trying to consider these things more broadly.
Jennifer Colamonico
When we look at a lot of these innovative drugs or curative drugs, it seems like part of the problem is that we have a really good mechanism to understand their impact on particular programs, as we just talked about. But there are drugs that the benefit accrues over much later than whoever pays for it. So commercial employers are going to pay for drugs that might be high cost, that have a benefit to Medicare down the line.
And, you know, is there is there a world in which there are you see policies emerging, you know, for perhaps curative drugs or really high cost generic, therapies where it almost becomes like a new funding mechanism, something where, you know, we might maybe the government pays for it, even though it's not technically in Medicare. But we know that Medicare is going to accrue benefits in some way.
I, I've heard that, you know, discussed over I don't know, it's probably been ten years and it hasn't exactly happened, but do you have any sense, that there could be some innovative policies around how do we pay for really high cost, but really critically important therapies?
Kevin Kirby
You're right that there's been a lot of conversation about that for selling gene therapies, and particularly some of my clients that are manufacturers of Car-T cell therapies, because particularly when before patients get to Medicare and even, you know, in Medicare, if they're on one Medicare Advantage plan one year and, and move to another the next year, the plan that pays for these expensive therapies might not always be the one that benefits.
And so there are people that think through, you know, is there some kind of unique financing mechanism, you know, like, can you have a bond or something like that that funds that payment for these things? And then it's payer picks up, you know, their share of this as the patient carries it forward. So there are you're right.
There's a lot of thinking that's going into how can we spread the cost of these things across all of the different payers, whether it's Medicare or private payers that benefit? There are a bunch of good ideas out there. None of them have really emerged. As you know, this is happening now, but I think it's a it's a great question for thinking through how we're going to fund some of these curative therapies in the future.
Jennifer Colamonico
Is there anything to learn there from I'm thinking like surgical techniques or surgical tools that have changed, you know, survival rates for particular surgeries or things? Or are there any, you know, as, as a researcher, I guess, or are there any, any places where you would look for ideas, or are those just so different from pharmaceuticals?
Kevin Kirby
It's a good question. A lot of the innovations that happens in surgeries and, you know, things that involve hospitalization bring down some of the cost to hospitals over time. And so they use that, to figure out how to better provide care within bundled payment systems. So they're incentives, they're exceptions to that. When you get to, you know, capital costs and funding, you know, different MRI machines and that sort of thing.
But I do think that the challenge of some of these challenging therapies and the cures they represent is a different category of problem.
Jennifer Colamonico
Yeah. That's interesting. Let's just quickly talk about the, issue of 340 B pricing. And like we're down now in the weeds of like people who know the lingo here. Right? So, but if you're anywhere in the pharmaceutical space or in the health system space, you know that this is an issue. So can you break this down?
You know, what's the basic issue? And, and what are the real challenges, that, that pharmaceutical companies face when navigating this arena when it comes to Medicare benefits.
Kevin Kirby
So the 340 B program, which is named after a section of statute.
Jennifer Colamonico
Not a very creative name.
Kevin Kirby
No, but it was designed to provide discounts to certain safety net entities that had been getting discounts before Medicaid rebates went into effect. And then when the Medicare rebate program was started, because of the way it was structured, it presented a real disincentive to continue providing discounts to these safety net entities. And so Congress stepped in and said, we're going to make a program so that these people can get discounts without driving up the manufacturers rebate costs and unintended ways.
So I think that was a deal that worked for people for a while. And then as hospitals started to try to leverage the program to expand, you know, the patients that were, in theory, getting the 340 B drugs and getting access to the discounts, the program really, really began to grow. And in particular, using contract pharmacies outside the hospitals has, you know, brought this discount.
I think, you know, my pharmaceutical manufacturer clients would argue beyond the scope, that Congress initially intended. And so the question is what is the appropriate scope? And then as the program gets more complicated, how do you deal with problems of duplicate discounts and other issues? Because the manufacturer is not supposed to pay a 340 B discount and a medicaid rebate on the same prescription?
But they know that that happens. How do you stop that? They're not supposed to pay a 340 B discount and inflation penalty on the same prescription, but it's some of the things that the IRA, it's just recently implemented. How are you going to deal with that. And so there's a a lot of really good questions about how 340 B evolves and how you give her the agency that administers it.
Do they have the right authority to issue regulations to clarify some of these questions? It's an area that needs further policy development. And right now you see that happening with, you know, people fighting things out. But I also think that there are conversations happening among stakeholders to try to think through, okay, what is the right solution?
And I think some of our HMO colleagues are, you know, convening alliances and doing things that, you know, really could help move the ball on this issue.
Jennifer Colamonico
So it's a big deal for pharmaceutical companies. And is it a do you see it as a point of leverage. And, you know, they want this fixed because it's not working as it was intended. So in order to do a it's one of those like you open the box right. You open the policy box and say, okay, let's fix this.
But does that then open the box to fix other things. So, yeah, I mean, I know the discussions have been going on, which is probably why they haven't been solved yet because, it's complex, but, you know, do you see this getting resolved soon? And what kind of trade offs do you think? They may have to make in order to fix this?
Kevin Kirby
So it's one of those issues, you know, much like the Affordable Care Act came in, how many, 20 years after the Clinton health care reform efforts, that people have been looking at for a long time. And I'm not sure that I'm a good enough forecaster to predict when that logjam is going to break. Because it always seems like, okay, this might be the year, but there's so much complexity that so far it hasn't been a year for any of these reforms.
So the question is, at what point does a consensus emerge, just as it did for the ACA and the IRA? You know, is there a point where there's enough of a consensus on how we can do this, that Congress will act? I would suspect that probably, you know, we're still another couple of years out. But I have been wrong about how fast consensus emerges in the past.
Jennifer Colamonico
Well, it's always slow, slow, slow, and then all of a sudden really fast. So it is often hard to predict.
So I want to ask you the magic wand question. You mentioned. There are no magic wands, but if you had one, given your extends of background and your knowledge of lots of the complexities here, what what legislative or regulatory changes would you recommend to improve how Medicare is able to kind of strike the better balance of, you know, pharmaceutical pricing, managing the cost of medications, and the need to continually innovate, in therapies, in new therapies and treatment.
Kevin Kirby
And I think the magic wand would probably go back to something you said earlier about, like, we're not doing a good enough job of measuring the value of some of these interventions. And so could you create perfect data? Because I think that a lot of why we're not doing a good job with setting up value based agreements and, you know, other kinds of value based care is that there's legitimate disagreement about how you measure the value of some of these interventions until you can create full transparency on all of the different ways that a product can create value for, and all of the different people that are going to benefit from that value, it makes it challenging to then decide how you based in agreement on prices to deliver that value. So I think that everybody wants to have some kind of system where we pay for only the things that work and not the things that don't, but without perfect data on what it is that works and doesn't it, that it makes it really challenging.
Jennifer Colamonico
Do you do you think we're getting closer? I mean, I feel like so many things have happened around data transparency and data liquidity and all these other things that our colleagues talk about. But is it really are we really getting closer to being able to to better measure these, these outcomes?
Kevin Kirby
I think that the data are improving. And I think that the way that different stakeholders in the system are, are thinking about them are improving. Also.
Jennifer Colamonico
This episode of Vital Viewpoints on Healthcare is sponsored by HMA Information Services. HMAIS is a subscription based service that provides state level data on publicly sponsored programs like Medicaid from the latest managed care enrollment, market share, and financial performance data to up to date RFP calendars and state by state overviews, HMAS has all the information you'll need to power your initiatives to success.
This podcast was produced by myself, Jennifer Colamonico along with Tiffany McKenzie in collaboration with our guests. The content is the property of Health Management Associates.
