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Jena A.B.,Harvard University | Jena A.B.,Massachusetts General Hospital | Jena A.B.,National Bureau of Economic Research | Stevens W.,Precision Health Economics LLC | And 2 more authors.
Journal of General Internal Medicine | Year: 2014

Momentum is building to replace the current fee-for-service payment system with value-based reimbursement models that aim to deliver high quality care at lower costs. Although the goals of payment and delivery system reforms to improve quality and reduce costs are clear, the actual path by which provider groups can achieve these goals is not well understood, in large part because the role of identifying and discouraging the use of low-value, high-cost services and encouraging the use of high-value, low-cost services has traditionally fallen to health plans, not provider groups. The shifting focus towards provider accountability for costs and quality promises to expand the role of provider organizations from mainly delivering care to both delivering and prioritizing it based on costs and quality. We discuss how progress on two important but challenging fronts will be needed for provider groups to successfully translate evidence into value. First, robust evidence on the costs and benefits of treatments will need to be developed and made easily accessible to provider groups. Second, provider groups will need to translate that evidence into systems that support cost-effective clinical decisions. © 2014, Society of General Internal Medicine.


Okrent A.M.,U.S. Department of Agriculture | MacEwan J.P.,Precision Health Economics LLC
Agricultural and Resource Economics Review | Year: 2014

We estimate a demand system for ten nonalcoholic beverages to disentangle effects of prices, expenditures, advertising, and demographics on demand for nonalcoholic beverages for 1999 through 2010. We find that changes in demographic composition of the population between 1999 and 2008 played a much bigger role in observed purchasing patterns for recently introduced beverages like soy, rice, and almond drinks, isotonic and energy drinks, and bottled water whereas changes in prices and advertising expenditures largely explained declining demand for milk, regular carbonated soft drinks, and coffee and tea. However, between 2008 and 2010, declining demand for most nonalcoholic beverages was largely driven by incomeled decreases in expenditures.

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