Authors
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Balancing Cost and Quality in Oncology: A Value-Based Care PerspectiveTravis Brewer, vice president of payer and public health strategy/relations at Texas Oncology, shared that value-based oncology care can achieve both cost efficiency and high-quality outcomes through integrated multidisciplinary teams, flexible payment models, and targeted treatment approaches.
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Use of Voluntary Alignment in the Next Generation ACO ModelUse of voluntary alignment attribution by Next Generation Accountable Care Organization (ACO) participants was limited. The authors highlight the reasons and describe organizational use cases via a mixed-methods approach.
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The Health Care Price Crisis Needs Policy SolutionsThis commentary, part of the Price Crisis campaign, calls for state and federal policy interventions that are needed to rebalance the market to enhance competition and provide value in health care.
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Understanding the Role of the Pharmacist in Clinical Oncology: Jody Agena, PharmD, MBAJody Agena, PharmD, MBA, director of pharmacy operations, Virginia Cancer Specialists, discusses the various responsibilities of the pharmacist within community oncology settings.
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Hands Down, COVID-19 Will Change Medical PracticeCoronavirus disease 2019 (COVID-19) has challenged us to incorporate technology into engaging, interacting with, and caring for patients, using televisits and video conferencing in ways that have previously been resisted or derided.
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Advancing Myasthenia Gravis Treatment Access via Guideline-Directed ExpertiseNew guidelines and advocacy enhance myasthenia gravis treatment access, promoting proactive management and improved insurance coverage for diverse patient populations.
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Clinical Outcomes in Heart Failure Monitoring: A Pooled Rates AnalysisThis systematic literature review and pooled rates analysis investigated the standard of care for patients with heart failure in the US post hospital discharge.
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The Future of IV and Subcutaneous Therapies in OncologyPanelists discuss how subcutaneous (SubQ) and intravenous (IV) oncology therapies will continue to coexist, with patient-specific factors guiding delivery method choices, while ongoing innovation and collaboration drive the growing integration of SubQ formulations as a convenient and adaptable option in cancer care.
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Improving Glycemic Control in Diabetes Through Virtual Interdisciplinary RoundsPatients with diabetes whose providers received advice from remote, virtual interdisciplinary rounds had a greater 1-year reduction in hemoglobin A1c than comparable patients.
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Research Landscape: Endocrine Therapies for ER+/HER2- Metastatic Breast CancerStephanie Graff, MD, concludes the discussion with thoughts on endocrine therapies in development for patients with ER+/HER2- metastatic breast cancer.
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Health Care Costs Associated With Unrecognized Progression to Late-Stage Kidney DiseaseUnrecognized disease progression is associated with higher health care costs both for patients with end-stage kidney disease and late-stage (stages G4-G5) chronic kidney disease.
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A Multistakeholder Effort in Pennsylvania to Improve the Accuracy of Reporting Fatal Drug OverdosesThe authors describe a novel training program for death certifiers in Pennsylvania, which has been designed to specifically focus on some of the main challenges in the death certification process and resulted in a useful model that can potentially be adopted by other states or municipalities.
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Value-Based Care Through Postacute Home Health Under CMS PACT RegulationsAmong a patient population defined by CMS postacute care transfer regulations, home health vs no postacute care was associated with reduced 30-day readmissions and costs.
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Pharmacist Hypertension Management Using an Electronic Health Record–Based ApproachThe authors studied the impact of a pharmacist intervention on blood pressure control compared with usual care.
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Predicting Mortality Risk Using the PREVENT Equation Across Diverse Racial GroupsThis study validates the Predicting Risk of CVD Events (PREVENT) score across diverse racial and ethnic populations, highlighting its effectiveness in predicting cardiovascular risk and mortality, regardless of race or ethnicity.
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Coverage With Evidence Development: Where Are We Now?Review of CMS’ coverage with evidence development program exposes a need to improve program transparency and clarify requirements and timetables for reporting to improve access to novel therapies.
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Value-Based Payment, the Safety Net, and Rethinking RiskSafety-net providers can benefit from demonstrations of condition-specific and defined-scope-of-practice alternative payment models that account for the nonfinancial as well as financial risks that providers face.
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Utilization Management and Physician BurnoutThis survey assesses physician experiences with utilization management and burnout and investigates whether there is a link between them.
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The Unintended Consequences of Medicare’s Wage Index Adjustment on Device-Intensive Hospital ProceduresThe authors found an association between Medicare’s wage index adjustment and the differential use of labor-intensive surgical procedures and medical device–intensive minimally invasive clinical procedures across the United States.
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Final Panel Thoughts on the Management of SMAPanelists discuss how spinal muscular atrophy (SMA) treatment will evolve over the next 5 years, likely incorporating improved gene therapy delivery systems, combination therapies, and rehabilitation models, while maintaining individualized approaches for each patient.
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Contributor: 3 Ways Technology Empowers PCPs and Patients to Transform the Health Care Experience and Improve OutcomesTech-driven connectivity and collaboration tools empower primary care providers (PCPs) to shepherd patient care, while simultaneously empowering patients to make more informed and strategic decisions about their own health and care journey.
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Inability to Access Health Care Due to COVID-19 Among Medicare BeneficiariesUp to one-fifth of Medicare beneficiaries were unable to access health care due to the COVID-19 pandemic in 2020.
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Addressing Financial and Socioeconomic Barriers to Precision NSCLC Care: Jonathan Thompson, MD, MSJonathan Thompson, MD, MS, explains how financial, insurance, and socioeconomic barriers limit equitable access to biomarker testing and advanced therapies, underscoring the need for provider advocacy and systemic support.
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High-Impact Trials at ACC.25 Signal Shift in Chronic Disease TreatmentExperts highlight groundbreaking research presented at the American College of Cardiology Annual Scientific Session (ACC.25), which emphasized a shift toward more personalized, evidence-based treatment strategies.
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Proactive Care Management of AI-Identified At-Risk Patients Decreases Preventable AdmissionsProactive care management for artificial intelligence (AI)–identified at-risk patients reduced potentially preventable hospital admissions.
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High-Risk Care Management Impact on Medicaid ACO Utilization and SpendingIn Massachusetts’ largest Medicaid accountable care organization (ACO), high-risk care management significantly reduced spending, emergency department visits, and hospitalizations, demonstrating that targeted strategies can manage health care costs amid budget constraints.
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Differences in Savings and Quality by Type of ACO Model2016-2018 Next Generation Accountable Care Organization (ACO) and Medicare Shared Savings Program cost and quality data show similar performance, suggesting that increasing financial risk to health systems may not affect performance.
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Projected US Savings From Biosimilars, 2021-2025Projected savings from biosimilars from 2021 to 2025 were $38.4 billion vs conditions as of quarter 4 of 2020 and were driven by new biosimilar entry. Savings were $124.5 billion under an upper-bound scenario.
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Identifying Good Candidates for Histotripsy to Treat Liver TumorsSome patients are better candidates than others for histotripsy to treat liver tumors, but ultimately, this treatment still requires a good multidisciplinary team, like any cancer treatment, said Shaun P. McKenzie, MD, FACS.
