Providers

Although the pembrolizumab 8 arm of I-SPY2 did not have strong enough results to continue onto phase 3, it does provide some insights and highlights the need for precision medicine to tailor approaches to treatment, said Rita Nanda, MD, associate professor, medicine, The University of Chicago Medicine.

Listening to patient concerns and issues and communicating with them can really help providers keep patients with breast cancer adherent to their hormonal therapies, said Erica Mayer, MD, MPH, assistant professor, medicine, Harvard Medical School.

While efforts to abate surprise medical billing, such as the kind that come from out-of-network emergency department visits, are currently being debated in Washington, DC, the kind of billing discussed here occurs when patients struggle to understand the difference between preventive health services, which are covered at no cost under the Affordable Care Act, and billing for services at a doctor’s visit for an illness, condition, or injury.

Rita Nanda, MD, associate professor, medicine, The University of Chicago Medicine, outlines the design of the I-SPY2 clinical trial and what the results have been so far.

Ensuring that prognostic or predictive tests to help make decisions regarding radiation therapy are accurate and clinically validated remains a challenge, said Corey Speers, MD, PhD, assistant professor, radiation oncology, University of Michigan.

More than 7 months after Scott Gottlieb, MD, resigned from his position as FDA commissioner, the Senate confirmed Stephen Hahn, MD, FASTRO, to be the next head of the agency.

The bar for who should get genetic testing for breast cancer keeps getting lowered, and oncologists have to keep informed about which results should trigger a referral for germline testing, said Nadine Tung, MD, director, Cancer Risk and Prevention Program, Beth Israel Deaconess Medical Center, and associate professor, medicine, Harvard Medical School.

Using biomarker tests can help personalize care for women with ductal carcinoma in situ and determine the risks of using or not using radiation, said Eileen Rakovitch, MD, MSc, FRCPC, professor, department of radiation oncology, University of Toronto.

Amy Ellis, director of quality and value-based care at Northwest Medical Specialties, and Amanda Hodges, director of implementation for ReVital Cancer Rehabilitation, who acts as a bridge between the oncology world and the rehabilitation world, discuss overcoming barriers in practices to help patients with cancer get the rehab care they need, how patients with cancer can benefit from rehab, and defining value.

Patients with hematologic malignancies receive less appropriate end-of-life care than patients with solid tumors because of barriers with patients, physicians, and the healthcare system in general, said Adam Olszewski, MD, associate professor of medicine at The Warren Alpert Medical School of Brown University.

New research shows that carfilzomib in newly diagnosed patients with multiple myeloma resulted in a higher rate of minimal residual disease negativity compared with usual rates, said C. Ola Landgren, MD, PhD, professor of medicine and chief of the Myeloma Service at Memorial Sloan Kettering Cancer.

Symptoms of myeloproliferative neoplasms (MPNs) have a large impact on quality of life for patients and it is important to be able to link them, said Ruben Mesa, MD, director of UT Health San Antonio MD Anderson Cancer Center.

While there are more novel therapies available to treat chronic lymphocytic leukemia (CLL), there are still unanswered questions about how to use these therapies in sequences, said Lindsey Roeker, MD, clinical fellow at Memorial Sloan Kettering Cancer Center.

Children with acute myeloid leukemia (AML) who come from neighborhoods with lower income have poorer outcomes and may have access to care issues, said Lena Winestone, MD, assistant professor of pediatrics at the University of California, San Francisco.

To avoid the toxicities associated with use of chemotherapy, there has been progress in developing and utilizing chemotherapy-free therapies to treat mantle cell lymphoma, said Michael Wang, MD, professor in the Department of Lymphoma and Myeloma at MD Anderson.

Patients with mantle cell lymphoma (MCL) face a substantial economic burden and susceptibility to adverse events (AEs) in the real world, according to an abstract presented at the 61st American Society of Hematology Annual Meeting and Exposition.

Accountable care organizations (ACOs) have saved Medicare a total of $3.53 billion from 2013 to 2017, or $755 million after shared savings were paid out, according to a new report from the National Association of ACOs (NAACOS).

Historically, patients with severe acute graft-versus-host disease (GVHD) and severe chronic GVHD as determined by the National Institutes of Health have poor survival. New research being presented at the 61st American Society of Hematology Annual Meeting & Exposition shows that earlier treatment with novel therapies can improve outcomes for these patients.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

Prescriptive analytics, not just predictive analytics, will make a difference in patient outcomes, said John Frownfelter, MD, FACP, chief medical officer of Jvion.

There are no cures available to patients with polycythemia vera (PV), who are first treated with hydroxyurea (HU); ruxolitinib is approved as a second-line therapy in both Europe and the United States for patients who are intolerant of or resistant to HU. Two abstracts being presented at the 61st American Society of Hematology Annual Meeting & Exposition explore the use of ruxolitinib in patients with PV, either in patients who first tried HU or had ruxolitinib as a first-line therapy.

This week, the top managed care news included research that may hold the key to slowing progression of multiple sclerosis; Humana says it is saving billions of dollars through value-based care; the challenges of rural healthcare delivery.

Here are the top 5 articles for the month of November.

The industry does not do a very good job of letting providers know there are ways to cover risk or protect against it. Better educating physicians on this would help improve uptake of value-based care models, said Mike Fazio, senior vice president of client services, Archway Health.

Hospitals in California are facing critical decisions on patient care; the FDA and CDC are investigating a multistate hepatitis A outbreak; 6 pharmaceutical giants are being investigated for their potential roles in the opioid crisis.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

Researchers may have identified a way to delay the progression of multiple sclerosis (MS) by blocking a molecule that controls the entry of B cells into the brain, which results in deterioration of tissue.

This week, the top managed care news included research that shows stents may offer no more value than drugs for some heart patients; a ban on flavored tobacco products gains momentum; a survey finds most American families struggle with social factors that impact health.

Healthcare needs to learn to adapt faster to changes, said John Frownfelter, MD, FACP, chief medical officer of Jvion.

The FDA has approved a new treatment for adult patients with acute hepatic porphyria (AHP) a rare genetic disorder. Givlaari is an RNA interference therapeutic targeting aminolevulinic acid synthase 1. Simultaneously, Alnylam Pharmaceuticals announced a new framework for value-based agreements to help patients gain access to the treatment.