Interviews

Patients with diabetes whose traditions and culture includes celebrations with food should not take a negative approach to lifestyle management and dietary restrictions, according to Andrew Pumerantz, DO, FACP, of the Western Diabetes Institute.

Patients with diabetes are entering a new era in which they can take charge of their own health and medical needs and come ready with questions and ideas to manage their disease, said Kerri Sparling, writer/editor of patient diabetes blog Six Until Me.

With various healthcare stakeholders having different wants and needs from the healthcare system, meetings that bring all parties together in one room are important, according to Suzanne F. Delbanco, executive director of Catalyst for Payment Reform, and keynote speaker at the spring live meeting of the ACO and Emerging Healthcare Delivery Coalition.

There are many cost-related pieces in the grand picture of care that are devastating to families and patients, including copayments, hospital visit bills, transportation fees, and drug prices.

As the human genome becomes more of a part of standard care, both the physician's responsibilities to his or her patients and the way care is delivered changes, explained Mark Kris, MD, William and Joy Ruane chair in thoracic oncology at Memorial Sloan Kettering Cancer Center.

When patients overestimate the benefits of intervention and underestimate the harms of treatments, they may not be receiving the right forms of care that they should be, said Austin Frakt, PhD, health economist and researcher.

Taking on the patient mindset, truly getting to know the patient and then incorporating the patient's caregiver team are ways that will better engage patients in their care, said Joseph C. Kvedar, MD, vice president of Connected Health at Partners HealthCare.

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 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.

Congressman Frank Pallone, Jr (D-NJ), explains the purpose of the National Institutes of Health Innovation Fund, which allows the organization to find cures for diseases that don't have 1 yet.

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.