Interviews

Amy Berman, BS, RN, says that all too often, people end up in the hospital because they don't know where else to go for treatment.

Scott Ramsey, MD, PhD, Fred Hutchinson Cancer Research Center, says that right now, only a small portion of health economics and outcomes research (HEOR) fits into the oncology model.

Dennis Scanlon, PhD, professor of health policy and administration at Penn State University, says there are a number of ways professionals continue to use data to improve delivery outcomes.

Peter B. Bach, MD, MAPP, director, Center for Health Policy and Outcomes, and attending physician, Memorial Sloan-Kettering Cancer Center, says there are a couple of challenges with the accountable care organization (ACO) and patient centered medical home (PCMH) care models.

Steven D. Shapiro, MD, executive vice president, chief medical and science officer, University of Pittsburgh Medical Center, says healthcare reform's biggest benefit is that it is leading care from a system that is volume based to one that is value based.

Len Nichols, director of the Center for Health Policy Research and Ethics (CHPRE) and a professor of Health Policy at George Mason University, discusses how hospitals can achieve the triple aim.

David B. Hoyt, MD, FACS, executive director, American College of Surgeons (ACS), says their National Surgical Improvement Program is designed to help hospitals evaluate where they stand with certain complications, and to then help them through a series of techniques to improve the care around those complications.

Chris Belmont, vice president and chief information officer, MD Anderson Cancer Center, says that health systems like Ochsner are using data to validate what they already know about certain patient cases.

Richard Umdenstock, president and chief executive officer, American Hospital Association (AHA), says hospitals have been preparing themselves for the influx of newly insured since 2010.

Toby Cosgrove, MD, president and CEO, The Cleveland Clinic, says the Clinic has been moving toward patient-centered care for almost a decade.

The American Journal of Managed Care recently sat with Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services (CMS), as she discussed CMS's role in the new, evolving healthcare landscape. This special AJMCtv interview highlights just some of the initiatives CMS has implemented, as well as some of the challenges that remain for the organization.

Margaret K. Pasquale, PhD, principal researcher, Comprehensive Health Insights at Humana, says Humana's predictive model of opioid abuse suggests that there are a few factors that might lend people to be at high risk for opioid abuse

Patricia Coyle, MD, director, MS Comprehensive Care Center, Stony Brook Neurosciences Institute, professor and vice chair of clinical affairs, Department of Neurology, SUNY at Stony Brook, says that prognostically, the earlier you treat multiple sclerosis the better.

Katherine Baicker, PhD, professor of health economics, Department of Health Policy and Management, Harvard School of Public Health, says that Medicare Advantage Plans still hold promise to deliver high-value, better-tailored care to beneficiaries.

Edmund J. Pezalla, MD, MPH, national medical director, Aetna Pharmacy Management, suggest that the healthcare industry will continue to move in the direction of providing patients incentives to make use of health risk assessment tools and screenings.

Joseph Antos, the Wilson H. Taylor Scholar in Health Care and Retirement Policy, American Enterprise Institute, says the federal Medicare program not only has a spending problem, but a delivery system problem that the fee-for-service model has not solved.

Dan Crippen, executive director of the National Governors Association, says the single biggest issue with state Medicaid programs is its significant impact on state budgets.

Bruce Feinberg, DO, vice president and chief medical officer, Cardinal Health Specialty Solutions, says that the populations of Medicaid and commercial patients have historically been different.

Matt Salo, executive director, National Association of Medicaid Directors, says there are many concerns associated with Medicaid expansion.

Melanie Bella, director, Medicare-Medicaid Coordination Office, Centers for Medicare & Medicaid Services, says the sole focus of the Medicare-Medicaid Coordination Office is to increase coordination and access to services from many fronts.

Jan Berger, MD, MJ, president & CEO, Health Intelligence Partners, and editor-in-chief of The American Journal of Pharmacy Benefits, says that historically medication adherence, when it pertained to PBMs, was really just about selling pills-it was an isolated, siloed issue.

Patrick Courneya, MD, CHIE, health plan medical director, HealthPartners, Inc, says that his organization sees a wide variety of models in Minnesota.

Patrick Gleason, PharmD, director of Health Outcomes, Prime Therapeutics, says there are many current and forthcoming trends in specialty pharmacy management.

Paul Ginsburg, PhD, president at Center for Studying Health System Change, says hospital mergers are increasingly building larger health systems.

Susan Dentzer, senior policy adviser, Robert Wood Johnson Foundation, says there are many trends that are transforming today's health insurance marketplace.

Tom Lee, MD, Founder and CEO, One Medical Group, says there are a wide variety of technologies that can enhance patient-centered care.

Bruce Feinberg, DO, Vice President and Chief Medical Officer, Cardinal Health Specialty Solutions, says cancer treatment is more than clinical guidelines, protocols, or individual drugs.

Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners, and editor-in-chief of The American Journal of Pharmacy Benefits, says that the availability of pharmacies nationwide presents a unique situation.