Interviews

In order to deliver quality and cost-effective cancer care, Michael Kolodziej, MD, Aetna's national medical director for oncology strategies, says that providers need to get better connected with payers.

Robert Williams, MD, director, Deloitte, Consulting LLP, says physician integration is driven predominantly by the department of justice, and FTC regulations that require physicians to meet the definition of clinical integration.

Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology, US Department of Health and Human Services, says that meaningful use sets a foundation for new models to deliver care to an entire population.

Peter Goldbach, MD, Chief Medical Officer, Health Dialog, says providers must engage their patients by communicating information about their health in efficient ways.

Patrick Courneya, MD, CHIE, Health Plan Medical Director, HealthPartners, Inc, says integration is not necessarily a description of a business model, but a description of a care model.

Karen Ignagni, President and Chief Executive Officer, America's Health Insurance Plans (AHIP), says health plans are doing a number of things to reduce cost and improve value, as they know the two go hand in hand.

The presence of inexpensive centers and new data collection tools show promise in cutting costs as providers take a new path in care delivery, says Eric Topol, MD, Director of the Scripps Translational Science Institute, Chief Academic Officer at Scripps Health, Cardiologist, and Professor of Genomics at The Scripps Research Institute.

Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners, and editor-in-chief of The American Journal of Pharmacy Benefits, says the triple aim consists of cost, quality, and access. Additionally, the largest benefit that healthcare consumers can use is their health pharmacy benefit.

Dea Belazi, PharmD, Vice President, Payer & Healthcare Solutions, Source Healthcare Analytics, says a copay assistance program is primarily sponsored or supported by a pharmaceutical manufacturer.

Surya Singh, MD, Vice President, Medical Benefit Management, CVS Caremark, says the buy-and-bill model is most typically applied to the provider space, and more specifically to physicians' offices.

Bruce Feinberg, DO, Vice President and Chief Medical Officer, Cardinal Health Specialty Solutions, says that the healthcare system today is fragmented, if not broken.

Susan Dentzer, Senior Policy Adviser, Robert Wood Johnson Foundation, says that there is growing interest in protecting healthcare providers from medical liability if they are following evidence-based protocols.

Patrick Gleason, PharmD, Director of Health Outcomes, Prime Therapeutics, says by 2017, 50% of all expenditures for drugs will be in the specialty drug space.

To create a strong sense of co-ownership between health systems and physicians, Robert Williams, MD, Director, Deloitte, Consulting LLP, says it's important to encourage physician engagement with organizations.

In this video, Karen Ignagni, President and Chief Executive Officer, America's Health Insurance Plans (AHIP), addresses the importance of joining The American Journal of Managed Care's Strategic Alliance Partner Program.

Charles Kennedy, MD, MBA, CEO, Accountable Care Solutions, Aetna Inc., says that part of an Accountable Care Organization's (ACOs) objective is changing how care is delivered.

"I think it's a really exciting time from a technology perspective," said George Van Antwerp, VP, Product Development, InVentiv Medical Management.

Michael Cropp, MD, MBA, President and Chief Executive Officer, Independent Health, believes Accountable Care Organizations (ACOs) are one of the current models redesigning the healthcare system.

Jeff Goldsmith, PhD, President, Health Futures, Inc, Associate Professor of Public Health Sciences, University of Virginia, says that the biggest barrier that accountable care organizations (ACOs) face is the lack of collaboration between physician communities and hospitals.

Paul Ginsburg, PhD, President, Center for Studying Health System Change, says that consolidation plays a role in healthcare costs regarding the shift in hospital and provider market power.

Rebecca P. Snead, RPh, the executive vice president and CEO of the National Alliance of State Pharmacy Associations discusses the current movement towards pharmacist provider status, and elaborates on the challenges and opportunities encountered.

In this video, Vandana Abramson, MD, assistant professor of medicine, Division of Hematology/Oncology, Vanderbilt University, Nashville, TN, discusses the various strategies utilized in the treatment of metastatic breast cancer.

Jacques Sokolov, MD, chairman and CEO, SSB Solutions Inc, says CIOs and ACOs are the foundation for many value-based products.

Patrick Gleason, PharmD, Director of Health Outcomes, Prime Therapeutics, says benefit design trends in specialty pharmacy show that the preferred specialty tier is generally a cost share of around one hundred dollars for a 30-day supply.

Renee Rayburg, RPh, Manager Clinical Pharmacy, OptumInsight, states that if providers narrowly focus on the traditional top down approach in specialty drug management they may miss out on opportunities for additional cost savings.

Christine Solberg Strahl, PharmD, Specialty Pharmacy Program Manager, HealthPartners, says that by managing specialty drugs before utilization patterns are established there is less member and provider dissatisfaction.

Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners, Editor-in-Chief, The American Journal of Pharmacy Benefits, says although Pharmacy Benefit Management (PBM) is becoming more sophisticated, providers are working to reduce confusion about benefit tier explanations.

Steve Melnick, President, SM Innovations, says that accountable care organizations (ACOs) will impact the pharmacy benefit by moving the healthcare system from a volume-based to a value-based model.