Inflammatory Bowel Disease Shared Value Initiative

There may be potential to accelerate uptake of value-based care for subspecialty conditions that experience high variability in cost and outcomes, sometimes described as “high-beta” conditions.[i] Inflammatory bowel disease (IBD), an umbrella term for two autoimmune diseases—ulcerative colitis and Crohn’s disease—impacts an estimated 3.1 million (or 1.3%) of Americans and is a high-beta condition that some stakeholders believe would benefit from value-based approaches, especially at a time of change in the treatment paradigm for IBD.[ii]

Tapestry is collaborating with clinicians, payers, industry leaders, patient advocacy organizations, and others on an effort to explore how consensus-based value frameworks and enhanced learning platforms can accelerate value-based care in this sub-specialty through a series of multistakeholder discussions. 

As part of this effort, a group of coauthors from these discussions published a collaborative payer-provider framework in Clinical Gastroenterology and Hepatology that established a shared vision of the principles necessary to enable value-based care and related incentives in IBD (e.g., new payment models or changes to utilization management practices like prior authorization). Tapestry is currently working with relevant stakeholders to advance real-world implementation of these principles.  

[i] Lawrence R. Kosinski, “Letter to the Physician-Focused Payment Model Technical Advisory Committee,” Department of Health and Human Services, December 21, 2016, iv.

[ii] James M. Dahlhamer et al., “Prevalence of Inflammatory Bowel Disease Among Adults Aged ≥18 Years — United States, 2015,” Morbidity and Mortality Weekly Report 65, no. 42 (October 2016), 1166–1169.