Collaborating towards greater value in inflammatory bowel disease care
There may be potential to accelerate uptake of value-based care and payment models 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]
In 2021-2022, Tapestry will collaborate 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 and new alternative payment models in this sub-specialty.
Project Background:
In May 2021, Tapestry Networks convened the IBD Progress Summit, an initial multistakeholder meeting to take stock of key challenges in IBD care that should be addressed to arrive at consensus-based approaches to promote value. Following the summit, stakeholders noted that establishing principles for value in IBD could help guide those looking to pilot new approaches, especially those responsible for contracting. With this in mind, a small group of payers and providers are working together to develop mile-markers for value-based care delivery and payment innovation in IBD, which will eventually be published and shared with the broader community. The author group continues to engage with other clinicians, relevant industry players (e.g., pharmaceutical and data infrastructure companies), patients, and others to hear their perspectives on these topics, including through an IBD Shared Value meeting in June 2022.
[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.
PUBLICATIONS
July 2022 As the Center for Medicare and Medicaid Innovation (CMMI) continues to advance value-based payment (VBP) models to address quality and total cost of care in primary care and large-
June 2021 Recent innovations have led to major change in the care of inflammatory bowel disease (IBD). Patients suffering from the chronic and debilitating disorders comprising IBD now have
