Interviews

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.

Richard Snyder, MD, Senior Vice President and Chief Medical Officer, Independence Blue Cross, says patient adherence programs can result in reduced emergency room visits and fewer hospitalizations.

George Van Antwerp, VP, Product Development, InVentiv Medical Management, suggests the pharmacy benefit manager (PBM) industry is truly exploring new ways of interacting with payers and providers.

Dea Belazi, PharmD, Vice President, Payer & Healthcare Solutions, Source Healthcare Analytics, says that medication adherence is a major keystone that allows a patient to achieve better outcomes in any therapeutic area.

"There is often a disconnect between research and policy," said Harlan Krumholz, MD, Department of Internal Medicine/Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT.

John Glaser, PhD, chief executive officer, Health Services, Siemens Healthcare, says that healthcare is going through a transformation based on payment reform changes.

Ira Klein, MD, MBA, FACP, chief medical officer, National Accounts Clinical Sales & Strategy, Aetna, addresses measurement programs used in oncology.

Dr. Mark Fendrick, MD, Professor of Medicine and Health Management and Policy, Schools of Medicine and Public Health, University of Michigan, Co-Editor-in-Chief, The American Journal of Managed Care, says that there are levers organizations and stakeholders can pull to achieve the goal of improving quality and value in cancer care.

Richard Stefanacci, DO, associate professor, Health Policy & Public Health, University of the Sciences, says that scanning and diagnostic testing are currently the most popular trend in neurodegenerative diseases.

Avik Roy, senior fellow, Manhattan Institute, says that health insurance exchanges will, over time, become the main method of delivering health insurance in the United States.

"There is a substantial number of risks associated with chemotherapy-induced nausea and vomiting (CINV)," said Susan Urba, MD, Medical Director, Symptom Management & Supportive Care Program, University of Michigan.

Ashish Jha, MD, MPH, associate professor of Health Policy and Management, Department of Health Policy and Management, Harvard School of Public Health, says that there are many challenges facing the quality of data used to transform healthcare delivery systems.

Dennis Scanlon, PhD, professor of health policy and administration, The Pennsylvania State University, says it is very important to bridge the gap between providers and payers in oncology management.

Bruce Feinberg, DO, Vice President and Chief Medical Officer, Cardinal Health Specialty Solutions, says that there is a tremendous amount of waste in the system.

Darius Lakdawalla, PhD, Director of Research, Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, thinks that payers follow the lead of providers in oncology management.

Peter B. Bach, MD, MAPP, Director, Center for Health Policy and Outcomes, Attending Physician, Memorial Sloan-Kettering Cancer Center, states that any organizational change that shifts payment and risk to providers will improve quality.

"Oncology is a very emotional area," says Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners, Editor-in-Chief, The American Journal of Pharmacy Benefits.

Gary Owens, MD, Gary Owens Associates, says that trends in rheumatoid arthritis (RA) management are coming from the new 2012 American College of Rheumatology guidelines that call for earlier and more aggressive treatment of new patients as well as patients who are not doing well on existing therapies.

Susan Urba, MD, Medical Director, Symptom Management & Supportive Care Program, University of Michigan, says that preventative medications given prior to treatment are necessary in order to improve the quality of life for patients with chemotherapy-induced nausea and vomiting (CINV).

In this video, Robert Bo Gamble, Director, Strategic Practice Initiatives, Community Oncology Alliance, Washington, DC, says that it is critical for payers and providers to come together in oncology management.

Martha Leclerc, Vice President, Office of Health Reform and Strategic Payment, Sanford Health, says that forming an accountable care organization (ACO) is a daunting task.

Mark McClellan, MD, PhD, director, Engelberg Center for Health Care Reform, Leonard D. Schaeffer Chair in Health Policy Studies, Brookings Institution, says that getting the best possible benefits of the healthcare system at the lowest cost is what really matters to patients.

Robert Galvin, MD, CEO, Equity Healthcare, The BlackStone Group, says that as a primary care physician he has a bias that the patient-centered medical home is a great model, but it is very difficult to implement.

Gail Wilensky, PhD, senior fellow, Project Hope, says that larger payers are introducing plans that reward consumers for choosing high-quality healthcare clinicians with lower co-payments and premiums. Dr Wilensky also says that there are many attempts to slow spending and improve quality.

Ross M. Miller, MD, MPH, Medical Executive, Cerner Corporation, says the advantages of health and care benefits for employees span across several areas.

Jacque Sokolov, MD, President, CEO, SSB Solutions, says that in order for clinically integrated organizations to drive revenue the clinical and business models must be coordinated, so incentives exist for revenue enhancement and expense control.