The Impact of Payment Reform on Industry Strategy

Titelangaben

Rupprecht, Carolin:
The Impact of Payment Reform on Industry Strategy.
In: Schmid, Andreas ; Singh, Simone (Hrsg.): Crossing Borders - Innovation in the U.S. Health Care System. - Bayreuth : P.C.O. , 2017 . - S. 135-147 . - (Schriften zur Gesundheitsökonomie ; 84 )
ISBN 978-3-941678-63-7

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Abstract

The following essay examines implications of new Centers for Medicare and Medicaid Services payment regulations, especially those stemming from the Medicare Access and CHIP Reauthorization Act (MACRA), which the medical technology industry faces in the health care market. Providers determine the coverage of medical devices within the constraints of Medicare’s payment systems and therefore are affected by new payment regulations. MACRA aims to improve the quality of care, advance care information distribution, and reduce health care costs, which can only be achieved together through enhanced care coordination and collaboration between different stakeholders. For the medical technology industry, success means that the paradigm shift from volume to value needs to be accepted at all levels. Medical device creators must better recognize consumer needs and establish systems to measure, monitor, and improve patient-centered outcomes. Moreover, companies need to understand their contribution to the full cycle of care through expanded collaboration between different stakeholders and participation in risk-sharing. Collaboration is also needed regarding electronic health records to make patient documentation simple and standardized. The medical technology industry is not directly integrated in Medicare’s payment reforms. As a result, it is their responsibility to demonstrate their value to patients, providers, and payers. In the long run, these different stakeholder needs must be integrated in the research and development of novel technologies.