Interviews

Picking the right measurements to assess improvement in medication management depends largely on the what group is being considered, said Woody Eisenberg, MD, senior vice president of performance measurement and strategic alliances for the Pharmacy Quality Alliance.

When Providence-Swedish Health Alliance signed with Boeing to create a unique employer-sponsored accountable care organization, figuring out the logistics of the model took some time, according to Joseph Gifford, MD, CEO of Providence-Swedish Health Alliance.

Many things that need to be refined in order to build successful learning health systems, including an infrastructure that supports learning and research and a better exchange of data and computer information.

Leah Binder, MA, MGA, president and chief executive officer of The Leapfrog Group, encourages everyone to attend The American Journal of Managed Care's ACO and Emerging Healthcare Coalition Fall live meeting, which will be held October 15-16 in Palm Harbor, Florida.

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.

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.