The most recent Medicare Advantage and Part D program audits revealed that oversight of formulary administration is an area that health plans continue to struggle with, Sarah J. Lorance, vice president of Medicare Compliance at WellPoint, said at America's Health Insurance Plans' National Conference on Medicare and Medicaid and Dual Eligibles Summit in Washington, DC.
The move toward an age of digital health will allow doctors to learn more and faster when it comes to drug toxicity and side effects, according to Peter P. Yu, MD, FASCO, 2014-2015 ASCO president.
Genetic and companion testing takes a village, according to Jan Berger, MD, MJ, president and chief executive officer of Health Intelligence Partners and editor-in-chief of The American Journal of Pharmacy Benefits.
Health information technology presents an exciting opportunity for researchers interested in applied work, according to Karen B. DeSalvo, MD, MPH, MSc, National Coordinator for Health Information Technology.
The only way to manage the massive amount patient data being collected today is by using big data in real time, according Dr Keith Dunleavy, president, CEO, chairman of the board for Inovalon, Inc.
Kimberly Westrich, director for health services research for the National Pharmaceutical Council, explained why accountable care organizations should consider medications an essential part of condition management.
Dr Peter P. Yu, MD, Emphasized the importance of value when considering the implications of cancer care.
Karen B. DeSalvo, MD, MPH, MSc, National Coordinator for Health Information Technology said the promise and power of health information technology in the world of public health is vast and growing.
Karen Lewis, MS, MM, CGC, medical policy administrator and genetic counselor at Priority Health, said that providers are engaging in genetic testing, but they are doing so in "an uninformed fashion."
Peter Paul Yu, MD, FASCO, who this summer became president of the American Society of Clinical Oncology, shared how the group is leading the discussion of what constitutes value in cancer care, as well as the need to engage all stakeholders in this critical topic.
Karen DeSalvo, MD, National Coordinator for Health Information Technology, said that while patients expect their medical records to be confidential, they are open to information sharing so long as it leads to improvements in their health or the health of others. Moreover, as Dr DeSalvo reveals, many patients expect their medical records to be digitized.
Len Nichols, PhD, director of the Center for Health Policy Research and Ethics (CHPRE) and a professor of Health Policy at George Mason University, describes how medical tourism improves care while lowering costs.
Richard Umdenstock, president and chief executive officer, American Hospital Association, says that many Americans who are newly insured have not had a high level of interaction with the healthcare system. Some people in this patient population might not even know that there are opportunities to engage with members in their community.
Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners, and editor-in-chief of The American Journal of Pharmacy Benefits, explains that next generation sequencing involves gaining a better understanding and deeper knowledge of the subject, not just another "test here or a test there."
Amy Berman, BS, RN, senior program officer at the John A. Hartford Foundation, says that the triple aim promotes better health, better care, and lower costs. All too often, however, current oncology treatment regimens do not achieve the triple aim.
Len Nichols, PhD, director of the Center for Health Policy Research and Ethics (CHPRE) and a professor of Health Policy at George Mason University, says that transparency in healthcare is an important concept.
Dennis Scanlon, PhD, professor of health policy and administration at Penn State University, says that it is important to consider what details patients need in order to make informed decisions. For payers, this might include informing consumers about enrollment decisions.
Farzad Mostashari, MD, CEO, Aledade Inc, former National Coordinator for Health Information Technology, says that the Blue Button Initiative is a concept that allows patients to receive a copy of their own health information and use it however they like.
Comparative effectiveness research (CER) collaborative tools can benefit pharmaceutical companies in a variety of ways.
It is well known that oncology care pathways are the tools that practices can utilize to care for its patients. Ira Klein, MD, MBA, FACP, chief medical officer, National Accounts Clinical Sales & Strategy, Aetna, suggests that Aetna's only involvement in creating these pathways should be in helping these practices develop "reasonable care pathways."
Michael Bousselot, policy advisor, Office of the Governor for the state of Iowa, believes that the Healthiest State Initiative effectively improves the populations' health and wellbeing because it is privately led and publicly endorsed.
Laurel Pickering, MPH, president & CEO of the Northeast Business Group on Health, explains that employers are transitioning employees into consumers with the help of "transparency tools" centered around price and quality.
While electronic health records (EHRs) enable Geisinger Health System to integrate and partner with new systems, Michael Evans, RPh, director, ambulatory clinical pharmacy programs, Geisinger Health System, suggests that the organization's pre-established managed care process is what sets Geisinger apart in the integrated delivery network/accountable care organization (IDN/ACO) marketplace.
Ed Cohen, PharmD, FAPhA, senior manager, product development, corporate innovations at Walgreens, explains that patient education and medication adherence are 2 major gaps in transitions of care.
Anthony Rothschild, MD, a professor at the Irving S. and Betty Brudnick Endowed Chair of Psychiatry, University of Massachusetts Medical School, says that many primary care physicians feel more comfortable prescribing newer anti-depressant drugs with fewer side effects.
Paul N. Van de Water, senior fellow, Center on Budget and Policy Priorities, suggests that controlling healthcare costs and spending is a complicated process - one in which no right answer exists.
Paige Cooke, assistant director, customer engagement, National Committee for Quality Assurance, says that primary care practices cannot effectively deliver patient-centered care without coordinating a patient's care across different healthcare settings.
Ira Klein, MD, MBA, FACP, chief medical officer, National Accounts Clinical Sales & Strategy, Aetna, suggests that oncology practices lack a sense of economic perspective that would otherwise allow them to offer a variety of services to their patients.
Leonard Fromer, MD, executive medical director, group practice forum and assistant clinical professor, Department of Family Medicine, University of California, says that proactivity and community collaboration are the best tools to aid transitions of care programs in new care delivery models.
