Interviews

Europe has found ways to make value-based care work, but the US market is very different, which means there are different factors in the United States that can work to encourage high-value care, according to Jennifer Graff, PharmD, vice president of comparative effectiveness research at the National Pharmaceutical Council.

Payers acknowledge obesity as a public health issue and are working to establish offerings that align with USPSTF recommendations in order to treat and prevent obesity, says Jenny Bogard, MPH, director of healthcare strategies at the Alliance for a Healthier Generation.

Public and private payment reforms such as accountable care organization contracts have shown some initial evidence of changes in physician behavior, but their full promise remains to be seen, according to Zirui Song, MD, PhD, resident at Massachusetts General Hospital.

Incentives must be aligned between payers and providers to transition to value-based care and physicians must have the best access to information to make the right decisions in these value-based arrangements, explains L. Patrick James, MD, chief clinical officer for health plans and policy, medical affairs, for Quest Diagnostics

The Alliance for a Healthier Generation believes in giving the youth the chance to live a healthier life and will continue to create healthier options at schools despite the current administration’s restriction reductions, claims Jenny Bogard, MPH, director of healthcare strategies at the Alliance for a Healthier Generation.

Being a nurse before being the director of the National Library of Medicine allowed Patricia Flatley Brennan, RN, PhD, a greater appreciation and understanding of the need for information at the point of care and a need to provide patients with information to practice self-care and self-management.

Payers recognize the importance of obesity care and prevention, but can find it difficult to justify and investment in a program that might not show benefits for years to come, explained Jenny Bogard, MPH, director of healthcare strategies at the Alliance for a Healthier Generation.

The forces pushing the country toward value-based care will continue regardless of who is in control in Washington, DC, said L. Patrick James, MD, chief clinical officer for health plans and policy, medical affairs, for Quest Diagnostics.

Emerging technology in the patient-clinician relationship and more rapidly developed data-driven knowledge will accelerate care, according to Patricia Flatley Brennan, RN, PhD, director of the National Library of Medicine.

As Hennepin Health expands its focus from the Medicaid expansion population of single adults to families and children, it will need to shift the way it views return on investment since there can be large upfront costs with returns happening years later with this new population, explained Ross Owen, health strategy director of Hennepin County.

Preventing the progression of diabetes can help patients maintain a healthy quality of life while saving significant costs, said Fatima Cody Stanford, MD, MPH, MPA, FAAP, FTOS, of Harvard Medical School and Massachusetts General Hospital.

The provision in the Affordable Care Act to remove cost sharing for preventive care visits created a shift in how Medicare pays with a greater emphasis on prevention and managing chronic diseases, and less on treatment of acute illness, said Mariétou Ouayogodé, PhD, post-doctoral fellow at The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth.

The National Library of Medicine (NLM) isn't a library in the traditional sense of a building with book and a librarian to help research, explained Patricia Flatley Brennan, RN, PhD, director of the NLM. NLM is a digitized envrinoment that connects people and researchers worldwide.

Heather Zacker, MS, senior director of Care Alliances of Joslin Innovation at Joslin Diabetes Center, discussed several ways primary care offices can transform their practices to provide optimal diabetes care. These include quality improvement, data analysis, and benchmarking initiatives to make the office more diabetes-friendly.

Fee-for-service payment models have not been successful in the field of palliative care, where small practices seem to work better under flexible programs like per member per month, said Allison Silvers, vice president of payment and policy at the Center to Advance Palliative Care.

According to Daniel J. Klein, president and CEO of the Patient Access Network Foundation, patients now have an easier time accessing the high-cost treatments they need, thanks to certain policies and programs. Klein also anticipates that a recently-passed law will bring down the prices of some prescription drugs.

There are changes and clarifications to definitions that are needed in the 340B program, but that won't likely happen anytime soon in this Congress. In the meantime, various stakeholders should take the time to educate one another on what the program means to them, said Neil Minkoff, MD, chief medical officer of EmpiraMed.

The Samfund is primarily known for its grant funding programs that help young adults with financial struggles after having cancer, but founder and CEO Samantha Watson discussed how the organization has expanded into providing financial literacy education and other tools to support the community of cancer patients.

The results of the EINSTEIN-CHOICE late-breaking trial comparing the effectiveness of rivaroxaban versus aspirin for preventing venous thromboembolism were presented at the American College of Cardiology 66th Scientific Session. According to Alex C. Spyropoulos, MD, FACP, FCCP, FRCPC, professor of medicine at the Hofstra Northwell School of Medicine, these findings could shift the paradigm of long-term thrombosis prevention strategies.

Racial or ethnic minorities are less likely to have insurance that covers treatments for obesity, even though they are at higher risk of the disease, explained Fatima Cody Stanford, MD, MPH, MPA, FAAP, FTOS, of Harvard Medical School and Massachusetts General Hospital.

Hennepin Health’s integrated approach to care coordination for complex patients requires a broader definition of care teams and clinics, explained Ross Owen, health strategy director of Hennepin County.

As a career employee in an increasingly partisan atmosphere, Patricia Flatley Brennan, RN, PhD, the new director of the National Library of Medicine, has the benefit of being one-step removed from political upheaval, while still being close to a political appointee to ensure her work is aligned with new policies.

One of the best ways to increase compliance when treating diabetes is to ensure patients fully understand the importance of treatment, according to Yehuda Handelsman, MD, FACP, FACE, FNLA, medical director and principal investigator at the Metabolic Institute of America. However, this can be difficult for physicians with a limited amount of time for patient visits.

On both sides of the patient-physician relationship, there are opportunities for improvement in communication and listening. In particular, healthcare providers must recognize patients’ capabilities and adjust their own communication styles appropriately, according to Allan Gibofsky, MD, professor of medicine and public health at Weill Cornell Medical College and an attending rheumatologist at Hospital for Special Surgery.

An analysis of Medicare accountable care organizations (ACOs) revealed that those with more primary care physicians performed better on preventive care quality measures and infrastructure and financing were also predictive of better performance, explained Mariétou Ouayogodé, PhD, post-doctoral fellow at The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth.

Oncology care management helps coordinate the clinical aspects of cancer treatment, but it would also be helpful to have a benefits manager to help guide patients through their many options, said Marianne Fazen, PhD, president and CEO of the Texas Business Group on Health.

At the PAN Foundation Cost-Sharing Roundtable, a variety of voices were represented from across healthcare to discuss the importance of the safety net, explained Daniel J. Klein, president and CEO of the Patient Access Network (PAN) Foundation.

Before Allison Silvers became vice president of payment and policy at the Center to Advance Palliative Care, she ran an information center that helped the elderly. In both of these roles, she has helped people make the best possible choices after evaluating all of their options.