WCOE: Comparing Health Plans, Motivating Change in Clinical Practice, the Sunshine Act, and Clinical Trials Protocols

Charles Ornstein, Lena Groeger and Ryann Grochowski Jones from ProPublica analyzed changes in plans under the Affordable Care Act (“Big Changes in Fine Print of Some 2015 Obamacare Plans”), and ProPublica developed an app that allows consumers in 34 states to compare premiums, deductibles, and other costs under 2014 and 2015 plans. If consumers choose to automatically re-enroll in the same plan, they may be faced with unanticipated changes to the plans. “Some policy changes appear subtle, just a matter of adding or subtracting a few words, but are actually quite significant,” the authors said.

In the ABIM Foundation’s blog post “Professionalism as a Means for Improvement,” Daniel Wolfson wrote about a method for implementing the Choosing Wisely recommendations that relies on behavioral economics and professionalism, rather than regulation or financial incentives.

A viewpoint piece in JAMA entitled “The Physician Payment Sunshine Act: Testing the Value of Transparency,” Sachin Santhakumar, and Eli Adashi described some of the implementation challenges and concerns about the data reported this fall under the Open Payments Program. The program, a topic of a panel discussion at a recent NCCS Cancer Policy Roundtable, reports payments by pharmaceutical companies to physicians. Despite the challenges, Santhakumar and Adashi concluded, “The OPP initiative must be viewed as the most potent antidote for potential conflicts of interest engendered by financial interactions between industry and the health care delivery enterprise. As such, it should be given the benefits of doubt and time.”

Finally, in a Forbes article, “Should The FDA Force Drug Makers To Discuss Their Clinical Trials?” former Pfizer executive John LaMattina advised pharmaceutical companies to have the Food and Drug Administration (FDA) review clinical trials protocols before beginning the trial to improve the chances a drug will be approved if the trial is successful. LaMattina said that requiring such review would be overkill, but concluded, “When it comes to avoiding FDA guidance, drug companies beware.”