Interviews

Based on past efforts like the Affordable Care Act and projected future trends, some level of government intervention will be needed to help the healthcare market offer patients access and choice at an affordable price, explained Daniel J. Klein, president and CEO of the Patient Access Network Foundation.

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 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.

CAR-T cell treatment can have a number of side effects, with the most serious being cytokine release syndrome, according to David L. Porter, MD, of the University of Pennsylvania Health System. However, there are some promising therapies like interleukin-6 blockers that can reverse this reaction.

Faced with an overwhelming amount of healthcare settings and information, patients with diabetes could find that digital health tools are a powerful resource for managing their illness, according to Heather Zacker, MS, senior director of Care Alliances of Joslin Innovation at Joslin Diabetes Center.

Providers have a responsibility to discuss the costs of cancer care with their patients earlier on, so the patients aren’t blindsided by enormous bills, said Samantha Watson, founder and CEO of The Samfund. These conversations would help patients prepare for the financial realities associated with cancer.

As more organizations begin to issue guidelines for the treatment of rheumatoid arthritis, they will incorporate recommendations to determine whether a drug is working. One option that can help give effective care and streamline patient managements is the use of the Vectra DA test, explained Grace C. Wright, MD, PhD, clinical associate professor of medicine and attending rheumatologist at New York University Langone Medical Center.

Aetna is in the process of transforming from a traditional health insurance company to becoming a healthcare-focused company, in part by emphasizing value-based reimbursement and social determinants of health, said Harold L. Paz, MD, MS, executive vice president and chief medical officer at Aetna.

It can be difficult at times for the Florida Health Care Coalition to meet the needs of every stakeholder, but the patient’s best interest is always at the center, said Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition. The organization works with task forces and advisory groups to find solutions that put the patient first.

Children need support from their families to fight obesity, as they lack the tools to change their diet and exercise patterns alone, according to Fatima Cody Stanford, MD, MPH, MPA, FAAP, FTOS, of Harvard Medical School and Massachusetts General Hospital. Getting obesity under control in childhood is key to reducing the risk of negative health outcomes later in life.

Behind the scenes there are a number of advances that Patricia Flatley Brennan, RN, PhD, director of the National Library of Medicine, would like to see take place to make it easier to get literature into people's hands.

Original research is necessary to overcome the challenges inherent in our healthcare system, in part by helping us fully understand various behavioral incentives, said Zirui Song, MD, PhD, resident at Massachusetts General Hospital.