Interviews

Contrary to concerns that telemedicine could be overused, some programs are seeing lower involvement than expected, according to Anne Schmidt, MD, associate medical director at Blue Cross and Blue Shield of Alabama.

The Oncology Care Model (OCM) can challenge providers who are overwhelmed by the wide scope of data involved, according to Barry Russo, CEO of The Center for Cancer & Blood Disorders. He explained the importance of educating staff, physicians, and patients to help ease the journey towards any new model.

Genomic-based solutions can help identify which cancer patients will respond better to treatment based on biomarkers, said David Fabrizio of Foundation Medicine, Inc.

Recent advances in insulin formulations and innovative drug classes have made it easier than ever to manage diabetic patients’ glucose levels, according to Yehuda Handelsman, MD, FACP, FACE, FNLA, medical director and principal investigator at the Metabolic Institute of America.

Precision medicine has demonstrated clinical utility and cost-effectiveness, which is why many believe this approach will be key to value-based cancer care in the future, said Jonathan Hirsch, founder and president of Syapse.

The Network for Excellence in Health Innovation finds potential areas of innovation and then tries to eliminate the obstacles to those ideas so its members can achieve the triple aim, according to Susan Dentzer, president and CEO of The Network for Excellence in Health Innovation.

Joseph Alvarnas, MD, of the City of Hope and editor-in-chief of Evidence-Based Oncology, admits that he was once “oblivious” to his patients’ concerns about the cost of cancer treatment. However, it is important for clinicians to empathize with these fears and understand how they can factor into a patient’s care choices.

As founder and CEO of The Samfund, Samantha Watson has found that most cancer patients prioritize their physical health over their financial stability, leaving them lagging behind their peers economically or even facing bankruptcy.

Investing in Project ECHO allowed Health Share to offer continuing education for providers, and many of them now say they enjoy participating in the program, said Christine Bernsten, senior manager of delivery systems transformation for Health Share of Oregon.

Carevive recognizes the importance of including patient-reported outcomes into the care planning process, so they have developed surveys that will provide patients with the resources to address those concerns, according to Carrie Stricker, PhD, RN, AOCN, chief clinical officer and co-founder of Carevive.

The spread of HIV has stabilized in some areas of the world, but continues to rise in others, said Thomas C. Quinn, MD, director of the Johns Hopkins Center for Global Health.

Surrogate endpoints could eventually add to or replace clinical endpoints in determining a cancer treatment’s effectiveness, according to Pam Mangat, MS, associate director TAPUR study at the American Society of Clinical Oncology. She also said that a deeper understanding of a patient’s genetic makeup and tumor biology in conjunction with new technologies will drive improvements in oncology care.

Through the use of workshops and other productions, the Texas Business Group on Health educates employers on how they can maximize value through oncology care innovations like precision medicine, according to Marianne Fazen, PhD, president and CEO of the Texas Business Group on Health.

Employers are generally not very familiar with the Oncology Care Model (OCM) yet, but support will grow as they see that the key goals of the OCM overlap with their own concerns, predicted Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.

As the opioid epidemic continues across America, more communities are providing their law enforcement officers with the drug naloxone (sold as Narcan) to reverse overdoses. Prosecutor Joseph D. Coronato of Ocean County, NJ, discussed the profound benefits he has seen as a result of the county’s naloxone program.

The emergency department presents a crucial opportunity to reach individuals after a drug overdose and convince them to seek help “while the teardrops are warm,” according to Ocean County, NJ, Prosecutor Joseph D. Coronato. He also explained how having continuous peer support after treatment is key to preventing drug relapses.

Patients and physicians both indicated on a survey that they would like to spend more time on visits, but often this is not feasible for physicians who are burdened with other time-consuming requirements like charting and billing, 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.

Immuno-oncology is often portrayed as having less severe side effects than chemotherapy, but patients need to be aware that it does carry some risks, said Debra L. Madden, cancer research advocate and patient representative. Patients should not hesitate to report any adverse effects to their doctor.

The Camden Coalition has hospital-based, community-based, and social work teams that work together to build relationships with patients, said Renee Murray, associate clinical director of Care Management Initiatives at Camden Coalition. Although each team member has a specialized role, they all pick up skills and learn from one another.

The transition to value-based care has been helpful in getting providers to examine their own performance and find ways to improve quality, said Andrei Gonzales, director of value-based reimbursement initiatives at McKesson Health Solutions.

CMS has been making efforts to reduce administrative burdens for physicians as the healthcare industry moves to value-based care through the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), said Mark McClellan, MD, PhD, director of the Duke-Margolis Center for Healthy Policy.

Research into the financial performance of Medicare accountable care organizations (ACOs) has found that organizations benefit from having prior experience with risk-bearing contracts, but that organizations that had reduced growth in healthcare spending before joining an ACO would find it difficult to improve further and share in savings, according to Marietou Ouayogode, PhD.

In Hennepin County, Minnesota, the local government has gotten into the business of healthcare and linked a variety of services into an accountable care organization (ACO) model that not only addresses beneficiaries' health needs, but also their social determinants of health, explained Ross Owen, health strategy director of Hennepin County..

The FDA has been willing to explore the utilization of surrogate endpoints like tumor response in clinical trials, but it is unclear whether these endpoints correlate with overall survival, said David Fabrizio of Foundation Medicine, Inc. However, he emphasized that overall survival does not necessarily benefit the patient if the additional days gained are not quality days.

Cancer Outcomes Tracking and Analytics (COTA) focuses on stratifying cancer patients by their many subtypes to understand the different treatments, outcomes, and costs for each, according to Stuart Goldberg, MD, chief medical officer, COTA, John Theurer Cancer Center.

In order to make palliative care accessible in every community, the Center to Advance Palliative Care works to educate clinicians, raise awareness among patients, and maintain adequate funding, according to Allison Silvers, vice president of payment and policy at the Center to Advance Palliative Care.

By 2020, more plans will incorporate value-based insurance design (VBID) principles as a way to lower cost sharing for high-value services and potentially increase cost sharing for low-value services, according to Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and director of the Healthcare Markets and Regulation Lab in the Department of Health Care Policy at Harvard Medical School.

The idea of risk sharing within value-based care is a wonderful concept, but it has not yet changed behavior and outcomes to the extent one would hope, according to Heather Zacker, MS, senior director of Care Alliances of Joslin Innovation at Joslin Diabetes Center. A potential reason is the variation in metrics and incentives used within different systems.