Special Issue: Payer/Provider Relationships in Oncology

Transformation

May 10, 2012

SPECIAL ISSUE

Journal of Oncology Practice (JOP) and The American Journal of Managed Care (AJMC) join efforts to highlight work focusing on issues affecting payers and providers.

Patient Out-of-Pocket Payments for Oral Oncolytics: Results From a 2009 US Claims Data Analysis

May 10, 2012

SPECIAL ISSUE

Out-of-pocket payments differ widely among oral oncolytic options. As cost for therapy becomes a greater part of treatment decisions, an understanding of patient out-of-pocket cost will be critical in informing choices.

Effect of Insurance Status on the Stage of Breast and Colorectal Cancers in a Safety-Net Hospital

May 10, 2012

SPECIAL ISSUE

In a safety-net hospital, patients with Medicaid have rates of advanced-stage cancer similar to those patients with other types of insurance; however, patients with no insurance have significantly higher rates of advanced disease.

US Payer Perspectives on Evidence for Formulary Decision Making

May 10, 2012

SPECIAL ISSUE

To improve formulary design processes and support payers in providing more effective healthcare, policy makers should consider involving commercial payers in the development of comparative effectiveness research and creation of research and treatment guidelines.

Evidence Gaps in Advanced Cancer Care: Community-Based Clinicians' Perspectives and Priorities for CER

May 10, 2012

SPECIAL ISSUE

Comparative effectiveness research and pragmatic clinical trials are valued methods to address the limitations of traditional randomized trials, answer questions of cost-effectiveness or noninferiority, and inform data-driven dialogue and decision making by stakeholders.

Treating ALK-Positive Lung Cancer in the Weeks After the FDA Approval of Crizotinib

May 10, 2012

SPECIAL ISSUE

As physicians enter a new world of therapies for molecularly defined lung cancer, it will be critical for hospitals, drug companies, and insurance companies to work out the interplay of molecular testing and coverage for expensive therapies that are effective but only in smaller, defined groups of patients.

Partnering With a Payer to Develop a Value-Based Medical Home Pilot: A West Coast Practice's Experience

May 10, 2012

SPECIAL ISSUE

The Wilshire Oncology Medical Group developed a medical oncology home pilot to offer a transparent, high-quality, high-value cancer program in partnership with its largest California health plan, Anthem Blue Cross WellPoint.

Payer Coverage for Patients Enrolled Onto Clinical Trials: Making the Process Easy and Transparent for Everyone

May 18, 2012

SPECIAL ISSUE

It is not just 1 physician who cares for a patient enrolled onto a clinical trial but rather a complex system of several physician teams, sometimes with very different opinions, who must work together for therapy to be successful and for the patient to have faith in his treating team.

Oncology Patient-Centered Medical Home

May 18, 2012

SPECIAL ISSUE

The oncology patient“centered medical home is a physician-driven, patient-focused value proposition that can make a difference for patients, oncologists, and the cost of healthcare.