After 25 Years, AJMC® Looks to the Future: A Q&A With Michael E. Chernew, PhD, and A. Mark Fendrick, MD

ABSTRACT

[...]as we turn to a new year and a new administration, I think my points would be to continue to grow on our bipartisan work, emphasizing that there is more than enough money in the US health care system. [...]it's our hope, particularly with a split government with no major health care policy changes on the horizon, that there will be continued attention to aligning health care costs with the essential nature of clinical services, that not only will barriers be removed for coronavirus disease 2019 (COVID-19) vaccines and COVID-19 treatments, but hopefully this would extend to other high-value services that are particularly used in the area of chronic diseases, and that we could pay for the added generosity of that coverage with the identification and reduction of low-value care, as put forth by Mike and I in a template called VBID X, a benefit design that lowers cost sharing on certain high-value services and is paid dollar for dollar by increasing cost sharing on either specific services or line items of services like high-cost imaging and nonpreferred branded drugs. [...]what we feel is that with the COVID-19 pandemic, lots of pain, lots of hardship, but as colleagues of mine from Tufts and I published in the September issue of AJMC®,1 there might be a silver lining in the fact that the dramatic reduction in both high- and low-value care that Mike and his colleagues from Harvard have continuously updated us on allowed us this ability to really inform all stakeholders that we could realign payment, benefit design, and other levers to increase efficiency, in that, while I've not been overly sympathetic to the provider community over my career, I've written in multiple venues that it's time to start paying clinicians and delivery systems more for some of these high-tech services that provide great value and hold them accountable for the services that might be very expensive and profitable but that don't make Americans any healthier. [...]my affinity for alternative payment models