Latest Conference Articles

The proposed changes to the Medicare Shared Savings Program may put a damper on the accountable care organization (ACO) movement, but ACOs remain the government’s best option for controlling healthcare costs, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.

There are some proposed changes to the Medicare Shared Savings Program (MSSP) that may be favorably or not depending on the accountable care organization (ACO) and its situation, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

After being treated for his chronic lymphocytic leukemia with chimeric antigen receptor (CAR) T-cell therapy, Brian Koffman, MDCM, DCFP, DABFM, MS Ed, medical director, CLL Society, is being followed for 15 years to better understand if there are any undiscovered adverse events that pop up and how durable the response is.

The way Washington, DC, works will make it difficult to enact any meaningful change that will cause a difference in how much patients pay for prescription drugs, said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.

As patients start chemotherapy to treat their cancer, they are educated on the side effects, particularly neutropenia, said Beth Wittmer, RN, OCN, manager of care management at Florida Cancer Specialists and Research Institute.

This administration is very focused on pharmaceutical pricing, explained Dan Mendelson, MPP, founder, Avalere Health.

Family physicians and internists, as well as emergency medicine and critical care medicine have the highest rates of clinician burnout, said W. Clay Jackson, MD, DipTh, clinical assistant professor of psychiatry, department of family medicine, University of Tennessee College of Medicine.

Thorvardur Halfdanarson, MD, associate professor of medicine and consultant in medical oncology, Mayo Clinic, outlines the biggest management challenges in neuroendocrine tumors (NETs).

Stigma is less prevalent now than it was 20 or 30 years ago, but people still often equate depression with weakness, explained Michael Thase, MD, professor of psychiatry and director of the Mood and Anxiety Program at the University of Pennsylvania.

There remain issues with benchmarking, attribution, and risk adjustment that CMS needs to address with accountable care organizations (ACOs), said Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System.

Since chimeric antigen receptor (CAR) T-cell therapy is still in early development there are benefits and risks that eligible patients will have to weigh, including the durable response against the limited amount of data and toxic side effects, said Brian Koffman, MDCM, DCFP, DABFM, MS Ed, medical director, CLL Society.

At a session of The American Journal of Managed Care®'s Patient-Centered Oncology Care® 2018 meeting, held November 16 in Philadelphia, panelists shared their views on the future of oncology value-based payment models and how they as payers and providers can help advance these models.

As practices shift to value-based care, they need truly coordinated care teams that discuss high-risk patients and identify ways to deliver care to them, said Marcus Neubauer, MD, chief medical officer, US Oncology.

Mergers and acquisitions are occurring in response to a change environment where organizations are trying to deliver a more comprehensive service, explained Dan Mendelson, MPP, founder, Avalere Health.

Aimee Tharaldson, PharmD, a senior clinical consultant in Emerging Therapeutics for Express Scripts, provides an update on recently approved speciality medications and which we will likely see approved in the remaining months of 2018.

The shorter timeline to risk and the reduction of shared savings rates are among the 2 greatest challenges accountable care organizations (ACOs) will face as part of the proposed changes to the Medicare Shared Savings Program (MSSP), said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

While the proposed changes to the Medicare Shared Savings Program (MSSP) won’t mean a large number of changes to Coastal Carolina Quality Care, the accountable care organization will have to make some changes to respond to the new Enhanced track, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.

Jane F. Barlow, MD, MPH, MBA, senior advisor, Center for Biomedical Innovation at Massachusetts Institute of Technology, discusses how curative, high-cost therapies will impact patient out-of-pocket (OOP) costs and cost sharing.

Thorvardur Halfdanarson, MD, associate professor of medicine and consultant in medical oncology, Mayo Clinic, discusses improvements in diagnostics for neuroendocrine tumors, as well as what improvements are still needed.

The proposed changes to the Medicare Shared Savings Program could prevent the program from driving broad change to value-based care across the country, according to Katherine Schneider, MD, MPhil, FAAFP, president and CEO of Delaware Valley ACO.

Somatostatins have been the most game-changing drug in the treatment landscape of gastroenteropancreatic neuroendocrine tumors, explained Scott Paulson, MD, co-director of the Gastrointestinal Research Program for The US Oncology Network, medical director for the Neuroendocrine Research and Treatment Center at Baylor Charles A. Sammons Cancer Center, Baylor University Medical Center.

One of the big issues that policy makers need to pay more attention to is how to reform Medicare, which has about 10 years remaining until the baby boomers aging into the program now start to see increased medical costs and needs, said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.

To speak about the success and continued development of Priority Health's payment reform model in cancer care, John Fox, MD, medical director at Priority Health, joined Dennis Zoet, chief business development officer at Cancer and Hematology Centers of Western Michigan, on a panel at the Community Oncology Alliance Payer Exchange Summit.

Heloisa Soares, MD, assistant professor, University of New Mexico Cancer Center-Albuquerque, outlines current barriers to achieving positive outcomes in neuroendocrine tumors (NETs) and what's in store for the future.

I’ve seen one case recently where a patient received $172,000 of drugs that were totally wasted. So, we’re going to be looking at this, we’re going to be looking at these middlemen getting in the way of the patient and the physician making a decision about their therapy, explained Ted Okon, executive director of COA.

Looking at total cost of care is difficult and figuring out what the practice is responsible for and not responsible for can be very difficult to do, said Lalan Wilfong, MD, executive vice president of Quality Programs at Texas Oncology.

A patient has their own set of values, providers have their own set of values, and the people that pay for it have their own set of values. So, [we all need to] come together, explains Bo Gamble, Director Of Strategic Practice Initiatives at the Community Oncology Alliance.

At the Community Oncology Alliance Payer Exchange Summit, healthcare policy experts from a government relations firm and from the pharmaceutical industry provided an update on the progress with value-based agreements and also discussed the challenges posed by the existing infrastructure and operational framework.