One of the most talked about subjects at the SCAI 2013 meeting was the Appropriate Use Criteria (AUC). There are great economic and potential implications associated with the designations of appropriate or inappropriate for specific diagnostic procedures and treatments.
Manesh Patel, MD, an interventional cardiologist at Duke University began by presenting a talk entitled, Appropriate Use Criteria: The Reasons, Methods, Intended, and Unintended Consequences. He first pointed out that Medicare expenditures on imaging have doubled between 2000 and 2006.
This session was perfect for the SCAI conference. Two opposing investigators were pitted against each other to debate 2 distinctly different treatment modalities. At the end of the debate, the physicians in the audience voted in live time in favor of 1 of the 2 treatments.
Dramatic changes in medical payment and economics began with the passage of the Affordable Care Act in 2010. Cardiologists weighed in on how this law is expected to impact upon their treatment decisions and business economics.
Sudden cardiovascular events are often preceded by embolus. The latest technologies for detection of emboli were showcased in a presentation by Emannouil S. Brilakis, MD, PhD, of the University of Texas, Southwestern Medical Center. Dr Brilakis presented Intra-coronary Infrared Spectroscopy to Predict Embolization Risk During PCI.
In the multi-part presentation entitled The Quality Mandate: Understanding New Regulatory Policies and Quality Superheroes, Robert Yeh, MD, a cardiologist at Massachusetts General Hospital (MGH), started the first session by reporting on the changing epidemiology of today's cardiovascular disease patient.
Lyndon Box, MD, is a cardiologist and contributor to the SCAI tool kit working at the University of Florida, Jacksonville. He opened up the session on quality and safety tools by discussing his most recent experience after accepting a position as the director of a new catheterization lab.
In the presentation Emerging Treatment Strategies for Acute Coronary Syndrome (ACS) Management: Improving Patient Outcomes, Frederick Korley, MD, an emergency medicine practitioner from John Hopkins, reviewed the role of available antiplatelet and anticoagulant agents for the treatment of ACS.
Russell Cohen, MD, says medication adherence is an important issue for inflammatory bowel disease (IBD), because patients must stay on medications long term. Dr Cohen comments, "IBD is a chronic relapsing condition, you don't just stop your medicines."
The realities of the emerging healthcare marketplace are quickly being recognized. Layna Cook, with law firm, Baker, Donelson, Bearman, Caldwell & Berkowitz, PC, discussed these realities with her presentation, The Impact of Health Reform's State Exchanges.
In this video, Vandana Abramson, MD, assistant professor of medicine, Division of Hematology/Oncology, Vanderbilt University, Nashville, TN, discusses the various strategies utilized in the treatment of metastatic breast cancer.
In the presentation Overcoming Challenges in the Management of Obesity: A Closer Look at Emerging Therapeutic Options, Trissa Reid, MD, an endocrinologist from the Columbia University Medical Center, reviewed the current concepts and practices around medical weight management.
With healthcare change comes challenge, but change also creates opportunity. This year's keynote general session for the NAMCP Spring Managed Care Forum was presented by Jacques Sokolov, MD, chairman and CEO, SSB Solutions, Inc, in Orlando, Florida.
Jacques Sokolov, MD, chairman and CEO, SSB Solutions Inc, says CIOs and ACOs are the foundation for many value-based products.
Martin Edelman, MD, Greenbaum Cancer Center, Baltimore, MD, says that organizations like NCCN and ASCO have guidelines for the management of non-small cell lung cancer (NSCLC).
Yelena Yankovskaya, PharmD, a managed markets fellow at the Mayes College of Healthcare Business and Policy, describes the expectations and roles of predictive modeling, value-based insurance design, and gamification/social media in contemporary managed care pharmacy.
In an educational symposium entitled, "The Evolution of Multiple Sclerosis Treatment: The Role of the Managed Care Pharmacist," Kristen Helms, PharmD, and her 2 colleagues discuss how treatments for multiple sclerosis (MS) have evolved over the past 2 decades, explore the novel and emerging therapeutic strategies for MS, and cover strategies to improve medication adherence for the chronic disease.
Daniel Tomaszewski, PharmD, PhD Candidate, an assistant professor at the University of Minnesota, College of Pharmacy, Duluth, discusses the impact of managed care pharmacy on current legislation, regulatory policies, and ongoing healthcare reform.
Eric A. Wright, PharmD, BCPS, an investigator at the Geisinger Center for Health Research, discusses the implications of medical moments of truth (MMOTs) on current therapeutic and managed care strategies.
In an educational session satellite symposium entitled "Biologic Therapies for Chronic Diseases: Factors Influencing Treatment Decisions," Robert P. Navarro, PharmD, along with his colleagues, delves into the current trends of specialty pharmacy and biological therapies, and how managed care discussions have evolved to optimize patient outcomes within a cost-constrained healthcare environment.
Rebecca P. Snead, RPh, the executive vice president and CEO of the National Alliance of State Pharmacy Associations, discusses the current movement toward pharmacist provider status, and elaborates on the challenges and opportunities encountered.
In an educational seminar entitled "How Much of the $3 Billion in Star Rating Bonuses Did Your MCO Capture?," David Nau, RPh, PhD, CPHQ, FAPhA, along with his colleagues, discussed Medicare star ratings and how managed care organizations have implemented practices and processes to ensure the delivery of high-quality care to their members.
Mattias Cheung, PhD, FCSHP, FASHP, discusses the ongoing progress of orphan drugs for rare diseases in today's health care environment, and explores their challenges and opportunities in the current managed care landscape.
Matthias Cheung, PhD, FCSHP, FASHP, a principal at Advanced Rx Consulting, LLC, and an adjunct professor of pharmacy practice at the University of the Pacific, Thomas J. Long School of Pharmacy and Health Services, discusses the circumstances and factors that catalyzed the passage of current legislation and regulatory policies for orphan drugs, rare diseases, and ultra-rare diseases.
Debora Sternaman, PharmD, the director of commercial formulary services at Catamaran in Georgetown, TX discusses the Health Insurance Marketplace and how the new model offers a different experience from the current managed care structure.
In a presentation entitled "Hemophilia Management: Collaborating in a New Era to Optimize Cost and Clinical Outcomes in Managed Care," 5 key thought leaders and managed care authorities shared their insights on the changing therapeutic landscape for hemophilia management.
Robert W. Dubois, MD, PhD, the chief science officer of the National Pharmaceutical Council discusses the initial expectations of implementing accountable care organizations (ACOs) and how those expectations have evolved over time.
In a presentation entitled "Accountable Care Organizations: 2013 and Beyond," 4 managed care experts shared their insights and thoughts on the ongoing paradigm shift in managed care towards accountable care organizations, elaborating on current trends, unmet needs, and the future direction of the managed care landscape.
The electronic health record (EHR) has been touted as a tool that has the power to improve the quality of patient care, reduce costs, and improve overall efficiency in healthcare. At this year's American College of Cardiology 62nd Annual Scientific Session and Expo, information was presented from a study challenging that long-held belief.
Frederick Masoudi, MD, Associate Professor of Medicine, Division of Cardiology, University of Colorado, says there has been an increase in focus on outcomes. They allow for systems accountability and focus on patient care.
