Oncology

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

AJMC®TV interviews let you catch up on what’s new and important about changes in healthcare, with insights from key decision makers—from the clinician, to the health plan leader, to the regulator.

Managed care and clinical updates in cancer treatment.

Speakers from major area cancer centers and Independence Blue Cross addressed progress in implementing value-based care initiatives during a session held September 19, 2019.

Speakers at the September 12, 2019, Policy Summit of the National Comprehensive Cancer Center, held in Washington, DC, addressed what practices have learned from experience with the Oncology Care Model and what steps must occur to standardize patient reported outcomes to incorporate them into reporting.

Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.

This week, the top managed care news included a new guide that balances curbs on opioid abuse with the needs of patients with chronic pain; HHS proposed reforming antikickback rules to help boost value-based care; a report found flaws with Medicaid work requirements.

In a commentary adapted from the organization's official response to CMS' proposal, the author highlights potential challenges that proposed alternative payment model presents for members of the American Society for Radiation Oncology (ASTRO).

Although results of other recent studies have noted the rise in the rate of obesity-related cancers among younger adults, this is the first study to also find a concurrent decrease in the rate of new cancer cases among patients 65 years and older.

Offering clinical trials is paramount, explained Bradley Prechtl, MBA, chief executive officer of Florida Cancer Specialists and the American Oncology Network.

Debra Patt, MD, MPH, MBA, an oncologist who specializes in breast cancer and who serves as executive vice president at Texas Oncology, discusses the effect of obesity on cancer treatment as well as prevention strategies.

Obesity is associated with a number of adverse health-related complications and carries an elevated individual all-cause mortality risk. It would be hard to overstate the increased adverse health outcomes for obese individuals. What is far less well recognized by the general public is the significant link between obesity and increased cancer risk.

Practices are going to have to decide which biosimilar manufacturers they want to be able to partner with, explained Tesh Khullar, senior vice president & advisor, Flatiron Health.

The most common primary liver cancer, hepatocellular carcinoma, is driven by fatty liver disease and is among the most prevalent and deadly of cancers driven by obesity. Rising rates of overweight and obesity parallel increased rates of obesogenic cancers, which increased 7% between 2005 and 2014.

Patients on Medicare with metastatic breast cancer who receive treatment that is discordant with NCCN guidelines bear a greater burden of patient cost responsibility than patients who do receive care according to treatment guidelines.

Initiating sustainable growth in clinical practices can be difficult, but through economies of scale derived from partnerships and performance data collection, optimal care can be administered efficiently, said Erich Mounce, chief operating officer, OneOncology.

Amila Patel, PharmD, BCOP, technical lead, Clinical Oncology, Flatiron Health, discusses how Flatiron is working to implement clinical workflow features that expand beyond the electronic health record (EHR).

Michael Kolodziej, MD, vice president and chief innovation officer at ADVI Health, Inc., outlines the trends he expects to see in the coming years that will impact oncology.

The healthcare system has gotten better at placing more of a priority on patient-centered care, but the progress has been slow, said James Hamrick, MD, senior medical director at Flatiron Health.

The mechanism studied affects a broad range of physiological responses and is now the focus of intense study by the pharmaceutical industry.

Lawrence N. Shulman, MD, director of the Center for Global Cancer Medicine at the Abramson Cancer Center, and professor of Medicine at the Hospital of the University of Pennsylvania, explains how providers are reacting to more effective, more costly therapies entering the cancer landscape.

Nina Chavez, MBA, FACMPE, chief operating officer, New Mexico Oncology Hematology Consultants, Ltd., explains how expensive therapies like chimeric antigen receptor (CAR) T-cell therapy are creating reimbursement challenges.

As practices work to provide the best care for their patients while also containing costs, it has become clear that the old ways of doing things won’t cut it.

During a panel discussion on defining, standardizing, and reporting quality in cancer care during the National Comprehensive Cancer Network Policy Summit held September 12 in Washington, DC, it became clear that stakeholders of all backgrounds have set their focus on one type of metric in particular: patient-reported outcomes.