
A new session at the Academy for Managed Care Pharmacy Nexus 2018 allowed for sharing ideas that have recently been put into practice.

A new session at the Academy for Managed Care Pharmacy Nexus 2018 allowed for sharing ideas that have recently been put into practice.

There has been dramatic growth in the number of labels relevant to precision medicine, but there remains a gap in the number available and what health plans actually cover, explained Kibum Kim, PhD, MSc, research assistant professor, University of Utah.

Dan Mendelson, MPP, founder, Avalere Health, outlines the impact recent healthcare policy changes have on pharmacists and providers.

A life-saving therapy is challenging to administer and poses financial risks for patients and institutions alike. Speakers at the Academy of Managed Care Pharmacy Nexus 2018 address some approaches to paying for it while CMS develops long-term policies.

Program audits are the chief tool used to evaluate how well health plans deliver care to an ever-growing share of Medicare's 60 million beneficiaries.

Real-world evidence helps to inform high-quality care in a number of different ways, and health information technology has really improved the quality and the caliber of real-world data available, explained Jennifer Graff, PharmD, vice president of comparative effectiveness research, National Pharmaceutical Council.

Christopher Diehl, PharmD, MBA, BCACP, clinical pharmacist, Excellus BlueCross BlueShield, discusses how the role of pharmacists has evolved with presence of value-based models and how pharmacists can ensure these value-based models succeed.

The combination therapy lets patients take a single pill once a day for treatment, which leads to improved adherence. Results of the study were presented at the Academy of Managed Care Pharmacy Nexus 2018 in Orlando, Florida.

A major bill to curb opioid abuse and the Trump administration's blueprint to rein in drug prices highlighted a busy year in the legislative and regulatory arena for the Academy of Managed Care Pharmacy.

The introduction of new curative—or durable—treatments has brought 3 challenges to the reimbursement landscape, explained Jane F. Barlow, MD, MPH, MBA, senior advisor, Center for Biomedical Innovation at Massachusetts Institute of Technology.

Current key market trends include biosimilar, cancer, and orphan drug approvals, explained Aimee Tharaldson, PharmD, a senior clinical consultant in Emerging Therapeutics for Express Scripts.

Express Scripts' Aimee Tharaldson, PharmD, gave her overview of the specialty pharmacy pipeline for 2019 and beyond at the Academy of Managed Care Pharmacy Nexus 2018 meeting in Orlando, Florida.

It’s fair to say that the initial results of immunotherapy in neuroendocrine tumors (NETs) have been somewhat disappointing, explained Thorvardur Halfdanarson, MD, associate professor of medicine and consultant in medical oncology, Mayo Clinic.

The proposed risk adjustment changes to the Medicare Shared Savings Program (MSSP) are welcome but moving accountable care organizations (ACOs) to risk too soon could harm the program, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.

The push to get accountable care organizations to take on risk faster could lead to more participation in Medicare Advantage, 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.

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, explains the current standard of treatment and novel approaches being taken in gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

CMS’ proposed changes to the Medicare Shared Savings Program (MSSP) doesn’t represent a major shift in policy stance toward accountable care organizations (ACOs), said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.

Heloisa Soares, MD, assistant professor, University of New Mexico Cancer Center-Albuquerque, discusses the importance of treating neuroendocrine tumors with a multidisciplinary team, as well as the importance of engaging patients and their families in their care.

By encouraging more providers to take on risk faster, the current administration may actually be disincentivizing providers from participating at all, which would reduce the number of accountable care organizations (ACOs), said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

Private payers are getting more engaged in accountable care organizations (ACOs), said Clif Gaus, ScD, president and CEO of the National Association of ACOs.

The proposed changes to the Medicare Shared Savings Program that move accountable care organizations (ACOs) to take on risk in just 2 years is not going to be enough time for most ACOs, although some may be ready in that time, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.

Contracts for accountable care organizations (ACOs) can be very different depending on who the payer is, according to Katherine Schneider, MD, MPhil, FAAFP, president and CEO of Delaware Valley ACO.

At the National Association of ACOs Fall 2018 conference, private payers discussed how they are working with accountable care organizations (ACOs) to create new opportunities in the commercial market.

During the opening plenary and panel at the fall 2018 meeting of the National Association of ACOs (NAACOS), Adam Boehler, of the Center for Medicare and Medicaid Innovation, highlighted the fact that CMS has to provide predictability and simplicity to get more accountable care organizations to take on risk and succeed, but that those who are not "cutting it" should "get out of the way" for others.

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, discusses how Mount Sinai’s accountable care organizations (ACOs) will have to adjust to the proposed CMS Medicare Shared Savings Program (MSSP) changes.

Two posters presented at the North American Neuroendocrine Tumor Society (NANETS) annual meeting, October 4-6 in Seattle, Washington, lend support to the idea of targeted treatment for neuroendocrine tumors.

During a session at the North American Neuroendocrine Tumor Society annual meeting, held October 4-6 in Seattle, Washington, Thorvardur Halfdanarson, MD, associate professor of medicine and consultant in medical oncology, Mayo Clinic, outlined the biggest news and updates in the treatment of neuroendocrine tumors (NETs).

During a session at the North American Neuroendocrine Tumor Society (NANETS) annual meeting, held October 4-6 in Seattle, Washington, Sukhmani Padda, MD, assistant professor of medicine, Stanford University Medical Center, gave an overview of updates made to lung neuroendocrine tumor guidelines.

Thorvardur Halfdanarson, MD, associate professor of medicine and consultant in medical oncology, Mayo Clinic, discusses peptide receptor radionuclide therapy and other new and exciting developments in the treatment of neuroendocrine tumors (NETs).

Accountable care organizations (ACOs) are of 2 minds right now. On the one hand, there is a lot of excitement for the future of ACOs, but there is also great anxiety around the changes that CMS proposed for the Medicare Shared Savings Program (MSSP), said Clif Gaus, ScD, president and CEO of the National Association of ACOs (NAACOS).

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