Interviews

In order to provide care to people with behavioral health issues early, in the primary care setting, Carolinas HealthCare System set up a virtual behavioral health provider team that can provide care to the 200 primary care offices and roughly 800,000 people in need that are part of the system, explained John Santopietro, chief clinical officer of behavioral health at Carolinas HealthCare System.

With the Affordable Care Act expanding access to healthcare coverage, health plans have to handle consumers who are very different: some are very new to healthcare, some are more knowledgeable, some are healthy and never use care, and some are chronically ill, explained Robin Wright King, MBA, of Blue Cross Blue Shield of Massachusetts.

There is much excitement over the new checkpoint inhibitors, which have shown benefit across a variety of tumors. Right now, researchers are trying to define the subgroup of patients with breast cancer who might be most suited to checkpoint inhibitors, explained Lee Schwartzberg, MD, FACP, chief of Division of Hematology Oncology and professor of medicine at the University of Tennessee Health Science Center.

Measurement is essential to improving care and having the equivalent measurements across the field will allow clinicians and providers to be held accountable for the care they provide, said Chip Kahn, president and CEO of the Federation of American Hospitals.

While at the National Comprehensive Cancer Network’s 21st Annual Meeting, John A. Thompson, MD, co-director of the Melanoma Clinic at the Seattle Cancer Care Alliance, discussed screening and diagnosis of melanoma, immunotherapy, and biomarkers.

In order for accountable care organizations to overcome short-term thinking they must be careful with their fee-for-service codes and ensure that people are using the system responsibly, Farzad Mostashari, MD, chief executive officer of Aledade, said at the National Association of ACOs Spring 2016 Conference.

The Medicare Part B demonstration has been controversial since its announcement, but Steven D. Pearson, MD, MSc, president of the Institute for Clinical and Economic Review, considers it a wise move on the part of CMS because it provides an opportunity to learn about different payment structures.

Patients and families can still have a limited understanding of palliative care, which may mean they have an open mind toward the suggestion, said Toby C. Campbell, MD, MSCI, associate professor of medicine, hematology-oncology at the University of Wisconsin School of Medicine and Public Health.

In addition to the federal government, state regulators and state insurance commissioners should play a role when considering regulation of recently proposed health insurance mergers, said Sarah Lueck, senior policy analyst from the Center on Budget and Policy Priorities.

When pricing new drugs, it’s difficult to understand how their performance will play out in the long term, and for that reason, Institute for Clinical and Economic Review (ICER) has created models that predict future costs and benefits, said Steven Pearson, MD, MSc, FRCP, founder and president of ICER.

Listening to patient-reported outcomes, especially in clinical trials, is extremely important, especially the array of technology available to collect this information, said Sophia K. Smith, PhD, MSW, associate professor at the Duke School of Nursing.

After beWellnm lost a major state insurer, the exchange changed its enrollment strategy and traveled throughout New Mexico to discuss the change in the market and remind the population about the assistance available, explained Amy Dowd, CEO of beWellnm.

Scottsdale Health Partners’ success is derived from its physician engagement, care coordination and transformation, and meaningful IT usage, explained James Whitfill, MD, chief medical officer. The organization has also learned that direct contact with both patients and provider is critical to continuing that success.

CDPHP created the “Inside Look: A Call for Rx Transparency” website in order to educate consumers about drug costs, and motivate people to price drugs in a more rational fashion, said John Bennett, MD, FACC, FACP, president and CEO of CDPHP.

With the recent increase of high-priced drugs, the idea of drug price negotiation in Medicare is receiving more attention as even Part D beneficiaries feel the pinch, said Tricia Neuman, ScD, director of the Kaiser Family Foundation's Program on Medicare Policy and the Project on Medicare's Future.

Florida Blue has experienced a huge surge in their Hispanic population membership and is working to understand and meet that demographic’s needs, said Anne Jessup, senior director of digital channels at Florida Blue.

If accountable care organizations (ACOs) are going to be successful, they need to learn from another and have meetings like the ACO & Emerging Healthcare Delivery Coalition's Spring Live Meeting, being held April 28-29 in Scottsdale, Arizona, to exchange good information, explained Michael Chernew, PhD, co-editor-in-chief of The American Journal of Managed Care. Dr Chernew will also sit on a panel discussion about the future state of healthcare in the United States during the ACO Coalition's meeting.

One of the greatest challenges for the healthcare industry as it moves to value-based payments is shifting from a short-term to a long-term mode of thinking, Farzad Mostashari, MD, chief executive officer of Aledade, explained at the National Association of ACOs Spring 2016 Conference.

Robin Wright King, MBA, of Blue Cross Blue Shield of Massachusetts, discusses consumer reactions to high-deductible health plans, which ask them to shoulder more of the burden of the cost of their healthcare.

Patients encountering high deductibles regarding medication in their Affordable Care Act plans can seek assistance from drug manufacturers by using copay programs, said Daniel J. Klein, president and CEO of the Patient Access Network Foundation.

Implementing an accountable care organization well without having gone through the process of getting patient-centered medical home designation is a struggle, Jill Watson, MBA, chief executive officer of The Kansas City Metropolitan Physician Association, said at the National Association of ACOs Spring 2016 Conference.

Changes with insurance products have led to more costs being shifted to consumers and they are having very mixed emotions when faced with high-deductible health plans, explained Niteesh Choudhry, MD, PhD, associate professor of medicine at Harvard Medical School.

Patient-Centered Diabetes Care (PCDC) is important because it provides a venue to share new knowledge and to meet different stakeholders that impact diabetes care, explained Robert A. Gabbay, MD, PhD, FACP, chief medical officer of the Joslin Diabetes Center, chair of PCDC, and editor-in-chief of Evidence-Based Diabetes Management.

Hurricane Katrina revealed the gaps in public health services in New Orleans, especially for those living in poverty, said Charlotte Parent, director of health of the New Orleans Health Department.

Scottsdale Health Partners has improved coordinated care on both a physical and a virtual level through the creation of a secure texting connection for real-time collaboration, James Whitfill, MD, chief medical officer of Scottsdale Health Partners, explained at the National Association of Accountable Care Organizations’ Spring 2016 Conference.

Florida has not been very good with healthcare cost transparency in the past, but there have been many new programs and tools introduced in order to remedy that, explained Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.

The move to value-based payment is going well, but the real work has to be done on the care transformation side, Farzad Mostashari, MD, co-founder and chief executive of Aledade.

How new technologies like mHealth and wearables may affect insurance providers and patient costs, according to Joseph C. Kvedar, MD, vice president of Connected Health at Partners HealthCare.