Interviews

CMS' shift to value-based payments has also shifted diabetes care models from cost-centered systems to cost-savings centers, according to Robert A. Gabbay, MD, PhD, chief medical officer and senior vice president of Joslin Diabetes Center.

Kerri Sparling, writer/editor at patient diabetes blog Six Until Me, knows from experience the importance of having a community support system when dealing with a chronic illness like diabetes.

Not providing a patient access to a learning health system is as unethical as it is to not allow a patient access to life-saving medicine, according to Sachin Jain, MD, MBA, chief medical officer at CareMore Health System.

As a part of the changing value-based payment model landscape, pay-for-performance programs for medication adherence measures are new for physicians and providers need help understanding the program, explained Mitzi Wasik, PharmD, BCPS.

Managing diabetes is about more than just blood-sugar elevation; discussions about management should go beyond medication adherence to include how the disease affects a patient's life, explains Andrew Pumerantz, DO, FACP.

There are a number of things that Paul Ciechanowski, MD, MPH, associate professor at the University of Washington, believes play a role in medication nonadherence among patients with diabetes, such as patient engagement in their care.

Jennifer Malin, MD, medical director for oncology at Anthem, explains how both physicians and payers struggle with the high cost of some cancer treatment drugs.

Taking into account all of the factors a patient may be dealing with is 1 way to address the growing cost of cancer care and its associated problems, like medication or treatment nonadherence.

Congressman Frank Pallone, Jr, discusses the origin of the 21st Century Cures Act and the work of the Energy and Commerce Committee to get discussion going about the bill.

While new care delivery models have provided better support for patients, there are still many patients who still face challenges with the complexity of treatment, explained Daniel J. Klein, president and chief executive officer of the Patient Access Network (PAN) Foundation.

The challenges in transitioning to value-based payments are rooted in cultural and environmental issues at those institutions that have never truly paid attention to value-based care, explained Joseph Gifford, MD, chief executive officer of the Providence-Swedish Health Alliance.

Since the National Quality Forum (NQF)'s birth in 1999, there have been 2 significant changes in the use of standardized healthcare quality measures, explains Christine K. Cassel, MD, president and chief executive officer of NQF.

As innovations in cancer care transform the disease into a chronic illness, the survivorship population encompasses more than early stage patients but survivors of long term metastatic disease as well, explains Crystal S. Denlinger, MD, Fox Chase Cancer Center in Philadelphia.

Christine K. Cassel, MD, president and CEO of the National Quality Forum, sent her best wishes to The American Journal of Managed Care for its 20th year anniversary in publication.

The world of value-based purchasing needs to quickly adopt the use of electronic health records and their ability to share data around a single patient, according to Christine K. Cassel, MD, president and CEO of the National Quality Forum.

Bruce Feinberg, DO, vice president and chief medical office at Cardinal Health Specialty Solutions, explains why he attends the sessions at Patient-Centered Oncology Care.

Dana Goldman, PhD, suggests that value for breakthrough therapies is most often associated with health benefits, health economics, and outcomes research; however, there are other sources of value that have not been taken into account yet.

Providing the cost of care beforehand will allow the patient enough time to understand what he or she may be getting into, similar to signing a contract, according to Austin Frakt, PhD, health economist and researcher.

Although GOP presidential hopefuls are all campaigning on promises to repeal and replace President Obama's Affordable Care Act (ACA), the last real chance to repeal may have been the 2012 election, according to Avik Roy, senior fellow at the Manhattan Institute.

Most patients expect that the healthcare system can already learn from every clinical encounter, but the reality is that is not happening yet, said Sachin Jain, MD, MBA, chief medical officer at CareMore Health System.

There are 2 strategies for addressing primary medication nonadherence that have seen success, according to Lauren Harner, JD, senior manager for policy at PhRMA.

Although there will be changes in the marketplace if the Supreme Court decision makes residents in states using HealthCare.gov ineligible for subsidies, it won't be anything that is irreversible, according to Thomas P. Miller, JD, resident fellow at the American Enterprise Institute.

One point of concern among Justices Anthony Kennedy and Sonia Sotomayor during the oral arguments of King v. Burwell was the issue of unconstitutional coercion, and Timothy S. Jost, professor of law at Washington and Lee University School of Law, explains the main issue.

Given that the subsidies in the federal exchange have helped to cover a lot of previously uninsured people, Chip Kahn, president and chief executive officer of the Federation of American Hospitals, remains encouraged the Supreme Court will "do the right thing."

Even though there hasn't been much public discussion from the Obama administration in regards to contingency plans should the Supreme Court rule in favor of the plaintiffs in King v. Burwell, there is likely much talk going on behind the scenes, explained Susan Dentzer, senior health policy adviser at the Robert Wood Johnson Foundation.

Leading up to the Supreme Court's decision in the case of King v. Burwell, Avik Roy, senior fellow at the Manhattan Institute, discusses in what ways Congress should potentially act if the plaintiffs receive a favorable ruling, who is to blame more if subsidies are removed from the federal marketplace, and how much time there will be for a patch to prevent millions of Americans losing financial assistance and subsequently their health insurance.

Bundled payments are the most manageable of all the Triple Aim models that focus on quality, improving patient experience, and total cost of care, according to Lili Brillstein, director of Episodes of Care at Horizon Blue Cross Blue Shield of New Jersey.

The US health industry is in the midst of a transformation to a value-outcome system, which is good for a learning health system, explained Lewis G. Sandy, MD, FACP, senior vice president of clinical advancement at UnitedHealth Group.

Most of the research in cancer economics has been on total cost and cost effectiveness, which is why Veena Shankaran MD, MS, assistant professor in the division of medical oncology at the University of Washington, wanted to have a panel discussion on financial toxicity at the ISPOR 20th Annual Meeting.

Aligning the care delivered with the patient's own desires is the biggest opportunity available to drive costs down while improving quality, according to Marc Boutin, JD, chief executive officer of the National Health Council.