Shifts in Provider Reimbursement and How Manufacturers Should Respond
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Value-based payments for providers are gaining momentum in the United States. Pharma and Biotech manufacturers, as well as other players in the ecosystem, must recognize how this changes provider incentives and behavior, and adjust accordingly.
The US healthcare system has long struggled with significant costs without a corresponding improvement in public health metrics. The US underperforms in a variety of public health metrics, yet spent 16.9 percent of GDP on healthcare in 2018, twice as much as the OECD average.
Part of the problem lies in the current dominant payment structures and the perverse financial incentives they create for providers. To give three examples that illustrated this even before the pandemic:
