
The move to quality ratings will put more pressure on hospitals to find ways to improve the standard of care while cutting costs.

The move to quality ratings will put more pressure on hospitals to find ways to improve the standard of care while cutting costs.

Glytec’s Glucommander electronic glucose management system (eGMS) helped the Kaweah Delta hospital shift its standard of care to basal-bolus insulin, explained Raymie McFarland, vice president of Quality Initiatives at Glytec. Basal-bolus is considered best practice and is safer for patients, but many hospitals have not adopted it due to its difficulty. Glytec hopes its eGMS can change that.

Constraining the cost of prescription drugs is a politically popular idea, but the same objective might be accomplished through evidence-based decision support for setting appropriate drug prices, according to Clifford Goodman, PhD, moderator at the ACO Coalition spring live meeting in Scottsdale, Arizona, and senior vice president and director at the Center for Comparative Effectiveness Research at the Lewin Group.

There are some areas in health policy where Democrats and Republicans can find common ground, like incentivizing greater value, but bipartisan talks won’t happen while there are still active efforts to repeal the Affordable Care Act, said David M. Cutler, PhD, of Harvard University.

The uncertainty in the political climate, along with the limited authority of the Health Resources and Services Administration within HHS, makes it difficult to predict whether the 340B program will be reformed in coming years, according to Leah Ralph, director of health policy at the Association of Community Cancer Centers.

Scott Ramsey, MD, PhD, of Fred Hutchinson Cancer Research Center, discusses determining cost effectiveness of novel treatments, such as immuno-oncology agents, and potential solutions to reducing financial toxicity in cancer care.

As the Institute for Clinical and Economic Review (ICER) prepares to update its final value proposal framework, it has been aided by the constructive comments from different stakeholders, said ICER president Steve Pearson, MD, MSc. He predicts that coming years will see continued interest in how to utilize such frameworks.

Working with real-world evidence-based data can pose difficulties, both when collecting and analyzing the information, but redesigned incentives could help drive entities to provide more information, said Lou Garrison, PhD, professor emeritus in the Department of Pharmacy, University of Washington.

While the political landscape is changing and new policies are being debated, lawmakers of both political parties can agree on the common goal of improving disease management for costly patients with complex health needs, according to Sachin H. Jain, MD, MBA, president and CEO of CareMore.

All stakeholders stand to gain from the 340B program in different ways, but they also take on different risks, like the potential impact for health plans on rebate contracts, said Neil Minkoff, MD, chief medical officer of EmpiraMed.

The main value of the COME HOME model for oncology practices is that it can help reduce hospitalization rates, leading to better quality of life for patients and clinicians, according to Barbara McAneny, MD, chief medical officer of New Mexico Oncology Hematology Consultants.

Studies presented at the 77th Scientific Sessions of the American Diabetes Association show that the combination therapy helps patients with the highest glycated hemoglobin levels gain control quickly.

The United States just went through a period of low spending growth, and if no one pays attention to it, the country might not be able to figure out what worked to cause this slow growth, said Gail Wilensky, PhD, of Project HOPE.

The CANVAS study’s outcomes were “a positive first step” in proving that canagliflozin can be used for the primary prevention of heart failure in patients with diabetes, but more evidence is needed, according to the study’s lead author, Bruce Neal, MB, ChB, PhD, of the George Institute for Global Health at UNSW Sydney, who presented the findings at the 77th Scientific Sessions of the American Diabetes Association’s in San Diego, California.

Hybrid closed-loop insulin delivery systems, also referred to as an artificial pancreas, can help improve the management of diabetes while researchers seek a cure, as well as provide reassurance for patients and their families, according to Eda Cengiz, MD, MHS, FAAP, associate professor of pediatrics at Yale School of Medicine.

Data presented by the FDA at the 2017 American Society of Clinical Oncology Annual Meeting identified a need for educating community-based oncology practices on testing for programmed death-ligand 1 (PD-L1) protein expression before patients diagnosed with metastatic non-small cell lung cancer (mNSCLC) are treated with nivolumab or pembrolizumab.

As healthcare organizations seek to expand the scope of data that patients can access, they must remain vigilant about cybersecurity and monitor the risk of data breaches and attacks, said Lee Barrett, executive director of the Electronic Healthcare Network Accreditation Commission.

A light-hearted format for the discussion at the 77th Scientific Sessions of the American Diabetes Association still brought out the seriousness of the issue: too many with type 2 diabetes have poor glycemic control, and another medication may not be the answer.

The long-awaited results from CANVAS show a reduced risk of cardiovascular events. The study's lead author said clinicians should balance the significant benefits of the drug against the potential harms for a small number of patients with known risks.

Results presented at the 77th Scientific Sessions of the American Diabetes Association are for combinations with ertugliflozin, an investigational SGLT2 inhibitor before FDA.

At a symposium at the 77th Scientific Sessions of the American Diabetes Association, experts suggested that the relationship between heart failure and diabetes is finally getting the attention it deserves.

Continuous glucose monitoring has the potential to revolutionize diabetes care for patients with type 2 diabetes, whether they are on insulin therapy or not, but the technology must be accompanied by stronger support from clinicians in order to be most successful, explained William Polonsky, PhD, CDE, president of the Behavioral Diabetes Institute and associate clinical professor at University of California, San Diego.

The studies are the first to focus on use of PCSK9 inhibitors in patients with diabetes. Alirocumab, sold as Praluent, is expected to report its cardiovascular outcomes trial in early 2018.

The Diabetes Prevention Program (DPP) has demonstrated that it can improve the quality of care for Medicare beneficiaries with diabetes while saving or maintaining costs, explained Nina Brown-Ashford, MPH, CHES, deputy group director at the CMS Innovation Center. Next, CMS will finalize the DPP’s expansion in another round of rulemaking.

No one questions the long-term savings that the Diabetes Prevention Program will bring to Medicare, but getting it off the ground will require several steps that have never been done before, including a new payment model.

The use of technology in behavioral interventions is exciting, but it is important to integrate the underlying principles of behavioral science when developing counseling interventions, explained Rob Nolan, PhD, CPsych, director of Cardiac eHealth at the Peter Munk Cardiac Centre and clinical psychologist and scientist at the Toronto General Research Institute, at the American College of Cardiology 66th Scientific Session, where he presented the results of the REACH eCounseling trial.

Diabetes management programs can be delivered digitally or in a traditional in-person setting, but there are benefits and drawbacks to each, explained Neal Kaufman, MD, founder and chief medical officer of Canary Health.

There are a number of exciting technological advances that could change diabetes care as we know it, such as improved continuous glucose monitors and convenient decision support tools, said Robert Gabbay, MD, PhD, chief medical officer of the Joslin Diabetes Center.

Ongoing legislative developments and the latest experiences with implementing alternative payment mechanisms are just some of the reasons Clifford Goodman, PhD, senior vice president and director at the Center for Comparative Effectiveness Research at the Lewin Group, is looking forward to the fall meeting of the ACO & Emerging Healthcare Delivery Coalition.

A measure developer's work isn't done once a quality measure is created-the Pharmacy Quality Alliance (PQA) works with health plans post-implementation on questions regarding measure specifications or measure calculations, explained Matthew Pickering, PharmD, RPh, associate director of research and quality strategies at PQA.

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