Michael J. Young, M.D., Asserts Value-Based Health Care Would Have Significant Economic Impacts to Reduce Medical Costs
Michael J. Young
Michael J. Young, Author
"Value-based Health Care would be a significant change and improvement in our means to assess the usefulness of a medical treatment, device or drug."
LOS ANGELES, CA, UNITED STATES, December 18, 2019 /EINPresswire.com/ -- The result is runaway costs. Medication costs are often two or three times higher in the U.S. than in most other developed countries. That’s because drug companies lower the price of their products in those markets to meet value-based reimbursement thresholds. In fact, after the U.K. rejected Ibrance for not returning a good value, the company lowered the price for the U.K. market.
How can we demand fairer prices — prices that reflect a medication’s actual value? Currently, when new drugs, devices or procedures come to market, Medicare coverage is based solely on a determination of benefit — does the new intervention help patients more than it harms them — without any regard to whether those benefits accrue at a reasonable price.
Michael Young, M.D., believes that the Medicare system needs to switch to a value-based system for economic improvements and accessibility. “Value-based Health Care would be a significant change and improvement in our means to assess the usefulness of a medical treatment, device or drug. However, it must be applied appropriately–and for the appropriate metric,” states Michael Young.
“Most often in the U.S., 'value' in the medical environment has been determined by an analysis of the volume, number, or measurement of time-spent on a particular problem or issue. Quantification of a chosen variable, as opposed to the quality of the results that stem from that intervention, drug, etc., end up being the metric used to assign reimbursement,” Young continues. “For instance, physicians are paid for office exams based upon the number of minutes spent with a patient, not necessarily how well, or even how effectively the time was spent. The number of 'questions' asked, or body system inquiries made (or at least entered into an electronic medical record) a physician makes during an examination are reimbursed–rather than assessing if the right questions were asked. Similarly, physicians are paid for tests and measurements. One must ask if the right tests are being performed and for the right reason. Drugs are priced based upon detailed evaluations of cost-of-development, marketing, and profit-margin expectations. How effective a particular medication actually is, appears to become a secondary concern in its price-point analysis,” concludes Young.
Medicare should switch to value-based reimbursement, with coverage decisions based on both benefits and costs. Such a change in reimbursement would have broader effects on our healthcare economy because when Medicare takes the lead in revising reimbursement, private insurers typically follow.
Michael Young is adamant that such assessments need to be checked. “I agree that in assessing reimbursement, value-based quality metrics should be used–at least partially. However, they cannot be the only parameter to assign value to medical treatment,” Young warns. “And such metrics must be applied only when appropriate. As an example, if a physician expends honest efforts for a patient, yet the patient succumbs to his or her disease or condition, the patient's lack of recovery should not be the only means to asses the provider's dedication and compensation. But value-based applications of determination of benefit can be readily applied to medical devices and drugs. If the device or drug performs as designed with measurable positive-patient outcomes, then reimbursement can more clearly be assigned,” states Young.
“So yes, Medicare should adopt and take the lead in revising its reimbursement requirements using a value-based methodology. This change would, indeed, have a significant economic impact in reducing skyrocketing medical costs of treatment and medication. But its use must be applied appropriately to those parameters best suited to this type of measurement.”
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Michael Young, M.D
Michael Young spent nearly 30 years as a surgeon while living and practicing medicine in Chicago. Young is currently on the faculty of the Department of Urology at the University of Illinois at Chicago. Within the department, Young is the Director of the Division of Urology Innovation and Technology. He works with bio-engineering and medical students, Urology residents and fellows, as they do their research in developing medical devices and surgical instruments. Young’s involvement in the medical field as a seasoned surgeon and educator led to his first book, "The Illness of Medicine."
"The Illness of Medicine" examines and reviews how one experiences medical treatment from both sides of the table. The significant obstacles patients endure, as well as the exasperation many of the truly dedicated medical professionals feel, has been assessed. The novel reveals how profit-driven corporations dictate how patient care is now governed while patients have essentially no control and doctors have lost the ability to direct their own profession.
Young is a man of many talents and in addition to his writing he is also a talented photographer, including underwater photography. His photographs are seen on his website, which is attached below. The doctor is a collector of modern art, a purposeful traveler, and an avid golfer.
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