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The Price of Innovation When Improving Cancer Care Delivery

Surabhi Dangi-Garimella, PhD
At the Association of Community Cancer Center’s 44th Annual Meeting & Cancer Center Business Summit, March 14-16, 2018, in Washington, DC, payer and physician representatives shared the stage with the president of a cancer foundation that is striving to break the barriers that prevent easy healthcare information exchange and access to cancer care.
Improving patient outcomes, ensuring the cost of care remains in check, and not losing sight of the patient at the center of it all—healthcare can be tough. And this transition to value-based care requires innovative approaches to care delivery by all involved.

At the Association of Community Cancer Center’s 44th Annual Meeting & Cancer Center Business Summit, March 14-16, 2018, in Washington, DC, payer and physician representatives shared the stage with the president of a cancer foundation that is striving to break the barriers that prevent easy healthcare information exchange and access to cancer care. Participants included Roy A. Beveridge, MD, chief medical officer, Humana; Barbara McAneny, MD, FASCO, MACP, president, American Medical Association (AMA); Anand Shah, MD, MPH, chief medical officer, Center for Medicare and Medicaid Innovation (CMMI); and Greg Simon, JD, president, Biden Cancer Initiative. Harlan Levine, MD, City of Hope moderated the discussion.

Levine asked the panelists to provide context to the audience, asking them, “Why are you on this panel?” on innovation in cancer care delivery.

McAneny said that AMA is working to create tools that would make things easier for physicians. “We are designing the workflow that physicians use to be the center piece. There’s a tremendous influx of data and we do not want to drown in it, but use it smartly,” McAneny said. She added that interoperability is a buzz word, but doctors want all the information on wherever their patients have been treated. “AMA has taken this up by setting a consortium to sort and transfer patient information within sites of care,” she added.

McAneny then moved on to discuss the influence of social determinants of health (SDH) on patient outcomes and cost of healthcare. There has been growing realization, among health policy researchers who have been studying this for a while and among providers, that environmental factors and where we stay have a big influence on our treatment outcomes.

“SDH is also high on our agenda. We are not measured based on a patient’s zip code,” McAneny said, but efforts are underway to develop measures, and a code, that account for SDH. “We need to level the playing field, to accounting for disparities,” McAneny added.

Payers recognize the influence of interoperability on efficiency, according to Beveridge. “The inability to exchange data is profound…we have been working with CMS to figure out ways to break data exclusivity and improve sharing [among stakeholders],” he said. He agreed with McAneny on the influence of SDH on not just outcomes, but also the cost of care. “In patients with malignancies, cost of care ranges about 2-6 times higher [among patients who face social challenges],” Beveridge said.

For Simon and his team at the Biden Cancer Initiative, interoperability is incredibly important. “We need to develop data-sharing models, launch virtual clinical trials, and we should conduct trials where people are,” Simon emphasized. He also underscored the importance of cross-pollinating innovative care models between health systems and community-based practices. “How can we let big cities know what’s happening in the community? We need to work toward creating standardized systems, and connectivity is key,” Simon said.

“CMMI is constantly trying to test new models and services, which can potentially reduce burden, because they require scale and the burden could potentially lead to consolidation. My role [at CMMI] is to make the system more accessible, affordable, and multi-stakeholder–driven for care providers,” Shah said.



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