Providers

Moving healthcare reimbursement from fee-for-service to a system that rewards quality care is easier said than done, but tools are emerging to help the cause. Three expert commentators featured in the inaugural issue of The American Journal of Accountable Care examined the challenges providers face, as they are being ask to share risk under new contracts with accountable care organizations, or ACOs.

During a Merck Serono-sponsored satellite symposium at the 29th Annual European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) conference, presenters shared research regarding patient engagement in treatment management for multiple sclerosis (MS). The presentation focused primarily on the relationship between patients with MS (PwMS) and their treating physicians.

In the final segment of the panel discussion, each panel member gave their final thoughts on the discussion topic.

After introducing panelists, Otis Brawley, MD, chief medical officer, American Cancer Society, David H. Finley, MD, FACS, national medical officer, Enterprise Affordability and Policy, Cigna Healthcare, Joy Larsen-Haidle, MS, genetic counselor, Hubert H. Humphrey Cancer Center, Ellen T. Matloff, MS, research scientist, Department of Genetics, director, Cancer Genetic Counseling, Yale Cancer Center and Rebecca Nagy, president, National Society of Genetic Counselors, moderator, Jan Berger MD, MJ, president & CEO, Health Intelligence Partners, editor-in-chief, The American Journal of Pharmacy Benefits, asked the panel to identify the current unmet needs and challenges in genetic testing.

David Lansky, PhD, President & CEO, Pacific Business Group on Health, says that Accountable Care Organizations (ACOs) must truly be accountable for the care they provide.

Panelists agreed that the cost of the new agents discussed to treat melanoma will be a challenge, just as the cost of healthcare as a whole in the United States is a major challenge.

Dr Fendrick asked panelists what they think about the idea of centers of excellence for specific cancers and an evidence-based steerage.

It's very, very complex to try to envision how you would come up with a single payment for an episode and not have a thousand different types of episodes in order to capture the heterogeneity of these diseases and the cost, said Dr Malin when asked to discuss the bundled payment method in oncology.

In this portion of the panel discussion, Dr Fendrick asked the panel whether or not they have noticed cost-related lack of access or nonadherence with the new agents being discussed.

Dr Weber said that despite all of the newer agents in development, the NCCN still offers comprehensive guidelines for the treatment of melanoma.

The American Journal of Managed Care and Precision Health Economics will hold a one-day meeting to promote better partnerships among all partners involved in diabetes management physicians, health plan leaders, policymakers, and the creators of life-saving medicines.

In this video, Karen Ignagni, President and Chief Executive Officer, America's Health Insurance Plans (AHIP), addresses the importance of joining The American Journal of Managed Care's Strategic Alliance Partner Program.

Daniel George, MD, Director, Prostate Clinic, Genitourinary Oncology, Duke Cancer Institute, specifically discusses the immunotherapy agent, sipuleucel-T (Provenge) used in the treatment of prostate cancer.

Jeff Goldsmith, PhD, President, Health Futures, Inc, Associate Professor of Public Health Sciences, University of Virginia, says that the biggest barrier that accountable care organizations (ACOs) face is the lack of collaboration between physician communities and hospitals.

In "What Does the Affordable Care Act Actually Do?," presented by Ivor Douglas, MD, Associate Professor, University of Colorado Denver, Chief, Pulmonary Sciences and Critical Care Medicine Director, Medical Intensive Care, Denver Health Medical Center, at the ATS 2013 International Conference, Dr Douglas noted that fundamental issues driving the Affordable Care Act (ACA) include access, quality, and cost.

Scott Halpern, MD, PhD, discussed the Choosing Wisely campaign with his opening presentation on The History of and Rationale for the Choosing Wisely Campaign. As most healthcare providers know, healthcare spending per capita in the United States is significantly higher than most other countries.

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.

Health plans are fundamentally transforming the delivery of healthcare for patients by reforming payment models, coordinating care, and partnering with providers.

We assessed Regional Extension Centers' (RECs') progress in promoting EHR adoption among providers in rural and health professional shortage areas and found that RECs are achieving much success in enrolling these providers.

Dr. Mark Fendrick, MD, Professor of Medicine and Health Management and Policy, Schools of Medicine and Public Health, University of Michigan, Co-Editor-in-Chief, The American Journal of Managed Care, says that there are levers organizations and stakeholders can pull to achieve the goal of improving quality and value in cancer care.

In this video, Robert Bo Gamble, Director, Strategic Practice Initiatives, Community Oncology Alliance, Washington, DC, says that it is critical for payers and providers to come together in oncology management.

New revenue models in healthcare are causing innovative payer-provider partnerships. John Harris, MBA, spoke about some of these new partnerships and how all stakeholders must consider each other's mindsets when choosing a model that works for them.