Interviews

The largest and perhaps most noticeable barrier standing between a successful collaboration of primary care physicians and specialists is the lack of communication, said Robert A. Gabbay, MD, PhD, chief medical officer and senior vice president of Joslin Diabetes Center.

Much of care coordination efforts for diabetes entail having the extra personnel to more closely manage patients and their behaviors, which in turn can improve medication adherence, said Paul Ciechanowski, MD, MPH, associate professor at the University of Washington.

The pay-for-performance model has come a long way in terms of how physicians are taking care of larger patients populations, according to Mitzi Wasik, PharmD, BCPS, director of Pharmacy Medicare Programs at Aetna, Inc.

The intersection of mental and physical health has been around now for quite some time, but the stigma attached to behavioral issues remains a barrier to patients getting the help they need, according to John Santopietro MD.

With various accountable care organization models that cover a wide range of health coverage plans, organizations with multiple models need to create a common framework for each market to follow in order to manage them.

Andrew Sussman, MD, president of MinuteClinic and senior vice president and associate chief medical officer of CVS Caremark, foresees a number of changes to come in terms of healthcare delivery in the US.

Although technology is becoming an increasingly important tool in healthcare, it should not be used with the intent to replace human care and relationships, explained Trishan Panch, MBBS, MP, chief medical officer of Wellframe.

Troy Trygstad, PharmD, MBA, PhD, vice president of pharmacy programs at Community Care of North Carolina, expressed the importance of a healthcare approach that concentrates on patient care and various delivery models that, in the end, promote long-term health and changes in health trajectory.

The introduction of biosimilars into the US market will not have a large impact on treatment costs until the volume of biosimiliars for different therapies increases, predicted Jennifer Malin, MD, medical director for oncology at Anthem.

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.

There are a number of things that Paul Ciechanowski, MD, MPH, associate professor at the University of Washington, believes play a role in medication nonadherence among patients with diabetes, such as patient engagement in their care.

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.