Interviews

Ken Cohen, MD, director of translational research for Optum Care, talks about the value of prior authorizations in different contexts, and how simplicity can benefit the process in some situations.

Hilary Tindle, MD, MPH, associate professor of medicine, at Vanderbilt University, discusses how the nicotine metabolite ratio (NMR) can help inform doctors and patients on choosing the optimal treatment for quitting smoking.

Susan Sabo-Wagner MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas, explained how cultural competency allows for better care delivery to patients with cancer.

Initiatives to address social determinants of health are likely to positively change the health care landscape, and better patient education can contribute to more favorable care choices says Ken Cohen, MD, director of translational research for Optum Care.

Creating new incentive models and transparently sharing data in a way that changes behaviors are 2 ways to reduce low-value care in the health care system, explains Ken Cohen, MD, director of translational research for Optum Care.

Michael Paull, MD, medical director of primary/urgent care and continuous improvement at the Vancouver Clinic (TVC), explained how TVC was able to improve its hypertension metrics to align with CMS' targets.

Hilary Tindle, MD, MPH, associate professor of medicine, Vanderbilt University, discusses the nicotine metabolite ratio (NMR) is and how it's used to help identify vulnerable individuals for lung cancer and heart disease.

Moving screening and prevention care more upstream can help make an impact by getting patients diagnosed with cancer earlier, said Susan Sabo-Wagner, MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas.

Ken Cohen, MD, director of translational research for Optum Care, speaks on the future of more biosimilars hitting the market, and how they will influence value-based care.

Hilary Tindle, MD, MPH, associate professor of medicine, Vanderbilt University, spoke about the use of precision medicine approaches, such as the nicotine metabolite ratio (NMR), to improve outcomes for patients with lung cancer.

Susan Sabo-Wagner, MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas, discussed how housing conditions can impede positive outcomes for patients with cancer who are receiving cancer care support at home.

Kristen K Ciombor, MD, MSCI, associate professor at Vanderbilt University, explains that results of neoadjuvant immunotherapy in colorectal cancer are promising, but long-term data is still needed.

Biosimilars are a wonderful option for patients, but the growing number available can be challenging to manage when different payers prefer different agents, said Susan Sabo-Wagner, MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas.

Paul Thurmes, MD, medical oncologist and hematologist, Minnesota Oncology, spoke on key responsibilities and approaches that are often lacking in cancer care.

Susan Sabo-Wagner, MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas, talked about the importance of having adequate support not only from clinical staff, but also emotional and moral support at home.

Hilary Tindle, MD, MPH, associate professor of medicine, Vanderbilt University, spoke on increased rates of smoking and lung cancer within a particular region of the United States called "Tobacco Nation."

Kyle Lamb, MD, associate medical director of population health at Vancouver Clinic, discusses how super-utilization trends have changed since the start of COVID-19, the necessity of transitional care in implementing value-based medicine, and how technology can decrease super-utilization.

Martin Levine, MD, MBA, chief medical officer at the PolyClinic at Optum Washington, describes why caregivers need more resources to adequately manage patients with Alzheimer disease and what clinics can do to ensure access to those resources.

Kristen K. Ciombor, MD, MSCI, associate professor at Vanderbilt University discusses why neoadjuvant immunotherapy is superior to other immunotherapy treatments in colorectal cancer.

During an Institute for Value-Based Medicine® event held in New York City, Samyukta Mullangi, MD, MBA, fellow in medical oncology at Memorial Sloan Kettering Cancer Center, discussed how disruptions from the COVID-19 pandemic are ushering in health care delivery reform.

There is a major role for telehealth in oncology care, not only for its convenience but also for giving clinicians the ability to scale nononcologic visits, explained Emeline Aviki, MD, MBA, FACOG, assistant attending gynecologic cancer surgeon at Memorial Sloan Kettering Cancer Center (MSKCC) in New York City and lead of the MSKCC Affordability Working Group.

Stephen M. Schleicher, MD, MBA, chief medical officer at Tennessee Oncology, addresses the “huge problem” of financial toxicity among patients with cancer, which can be attributed in part to both the high price of targeted treatments and even from ordering only necessary testing.

With multiple biosimilars approved for a reference product and different payers preferring particular products, communication between the clinical pharmacy team and the managed care team is crucial, said Timothy Murphy, MD, FACP, medical oncologist/hematologist with Rocky Mountain Cancer Centers.

Having a plan in place to educate providers and the pharmacy team has contributed to the success that Rocky Mountain Cancer Centers (RMCC) has had with rapidly implementing biosimilars, said Timothy Murphy, MD, medical oncologist/hematologist with RMCC.

Biosimilars have had such an impact on driving down costs, that in some instances the reference product might be the lowest cost option, explained Paul Forsberg, PharmD, director of pharmacy, Minnesota Oncology.

Even though there is a 1-year gap between the Oncology Care Model and the Enhancing Oncology Model, there remain value-based oncology payment programs with private payers, said Glenn Balasky, executive director of Rocky Mountain Cancer Centers.

With more and more biosimilars reaching market, there are considerations around whether to keep patients on their current biosimilar or switch them to another biosimilar as the market dictates, said Paul Forsberg, PharmD, director of pharmacy, Minnesota Oncology.

Lung cancer screening rates remain low nationwide, and there is a need to better educate patients and clinicians about the importance of screening, said Ticiana Leal, MD, associate professor, director of the Thoracic Medical Oncology Program, Department of Hematology and Medical Oncology, Emory University School of Medicine.