
Healthfirst's Medicare Advantage members are largely low income, and actually poorer than its Medicaid members. In order to reach these members and foster trust, Healthfirst makes itself a part of the fabric of the community.

Healthfirst's Medicare Advantage members are largely low income, and actually poorer than its Medicaid members. In order to reach these members and foster trust, Healthfirst makes itself a part of the fabric of the community.

The Affordable Care Act’s changes in payment and reduction in benchmarks in Medicare Advantage raised questions about the future of the program that ended up being unfounded, said Sean Cavanaugh, deputy administrator and director of the Center for Medicare at CMS, during the opening keynote at America’s Health Insurance Plans’ National Conference on Medicare, held October 24-25 in Washington, DC.

Panelists in the Healthcare 2020 series discuss the challenges with the exchanges that will be waiting for the next president, the future of Medicaid expansion, and how the complexity of so many models is burdening ACOs.

Accountable care organizations (ACOs) have been laying the groundwork for the requirements for the Medicare Access and CHIP Reauthorization Act (MACRA), which will give physicians participating in ACOs an advantage during the implementation of the new Medicare payment system, said Katherine Schneider, MD, president of the Delaware Valley ACO.

The innovative strategy of hotspotting, implemented by the Camden Coalition of Healthcare Providers, was the focus of a session and a panel discussion during the first day of the ACO & Emerging Healthcare Delivery Coalition.

Panel members discuss the level of physician awareness regarding changes that will follow the implementation of CMS’ recently released Medicare Access and CHIP Reauthorization Act (MACRA).

To create flexibility during the transition to the payment system under the Medicare Access and CHIP Reauthorization Act (MACRA), CMS has created something called “pick your pace,” explained Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.

In the keynote speech at the ACO & Emerging Healthcare Delivery Coalition, Mark McClellan, MD, PhD, director of the Duke-Margolis Center for Health Policy, started out by providing a broad picture of Medicare reform before narrowing it down to what is happening on the ground.

Healthcare attorney James M. Daniel, Jr, JD, MBA, explained how healthcare providers will be impacted by CMS’ newly released final rule on the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) in a session during the second day of the ACO & Emerging Healthcare Delivery Coalition.

Over the last 4 years, the ACO & Emerging Healthcare Delivery Coalition has continued to grow as a result of the opportunities to hear about innovations in accountable care organizations (ACOs) and to network with a diverse group of people, said Anthony Slonim, MD, DrPH, president and CEO of Renown Health and chair of the ACO Coalition.

The hotspotting technique that Camden Coalition of Healthcare Providers uses to care for complex patients shifts away from breaking people into segments based on disease, and looks at the whole make up of a person, considering every disease or social complexity that may be in effect, explained Renee Murray, associate clinical director of Care Management Initiatives at Camden Coalition.

The Camden Coalition of Healthcare Providers utilizes hotspotting to identify the most complex and costly patients and enrolls them in a care management program to empower them to take control of their own healthcare.

The FDA has already approved 4 biosimilars in the United States, but there remains a lot of uncertainty surrounding some of the legislation and regulation.

During the second day of the Academy of Managed Care Pharmacy 2016 Nexus meeting in National Harbor, Maryland, 2 speakers from Humana outlined how merging economics with psychology and sociology has helped them improve medication adherence and nudge their members into making healthier choices.

Even when following clinical guidelines, some patients will respond far better to treatment than others, and some will have worse side effects than expected. During a session at the Academy of Managed Care Pharmacy 2016 Nexus meeting, Nicole Scovis, PharmD, BCPS, BCACP, and Sandra Leal, PharmD, MPH, both of SinfoniaRx in Tucson, Arizona, explained how precision medicine can be integrated into primary care practice to improve care.

Legislation regarding the promotion of healthcare economic information is outdated and does not reflect the changes that have occurred since the FDA Modernization Act (FDAMA) was passed in 1997, contended speakers at the Academy of Managed Care Pharmacy’s 2016 Nexus, held in National Harbor, Maryland, October 3-6.

Perennial favorite, Aimee Tharaldson, PharmD, senior clinical consultant of emerging therapeutics at Express Scripts, opened the Academy of Managed Care Pharmacy 2016 Nexus, October 3, 2016, in National Harbor, Maryland, with a discussion of specialty pharmaceutical drugs in the pipeline.

The 4-part lecture, “Practical Application of Novel Targeted Strategies in Moderate-to-Severe Atopic Dermatitis” covered the pathogenesis of atopic dermatitis (AD), new insights into the pathophysiology in AD, considerations for change in the treatment of AD, and the latest developments in treatment.

Positive data from two Phase 3 clinical trials that show Dupixent (dupilumab) is effective in the treatment of moderate-to-severe atopic dermatitis was announced at the 25th European Academy of Dermatology and Venereology Congress in Vienna, Austria.

Demonstrating the efficacy of antiretroviral therapies and other treatments in preventing the spread of HIV, Thomas Quinn, MD, showed that there is hope for decreasing HIV transmissions across the world. He cautioned, however, that HIV/AIDS still remains a global pandemic, and more work must be done to accelerate the rate of decrease in HIV infections.

For a long time, researchers were unsure if atopic dermatitis was primarily a barrier disease or an immune-driven disease, but dupilumab has provided a more clear-cut answer, said Emma Guttman-Yassky, MD, PhD, of the Icahn School of Medicine at Mount Sinai Medical Center in New York.

Timothy M. Johnson, MD, spoke enthusiastically about the possibilities of sentinel lymph node biopsy in his lecture at the 25th European Academy of Dermatology and Venereology Congress in Vienna, Austria. His presentation, called “Melanoma Sentinel Node Biopsy: Past, Present and Future in the New Era of Systemic Therapies,” covered guidelines for the procedure as well as new possibilities for melanoma patients.

Thursday at the 25th European Academy of Dermatology and Venereology Congress in Vienna, Austria, 2 presentations focused on the effects of crisaborole topical ointment, 2%, in treating atopic dermatitis.

Patients with melanoma have more promising options than ever with the advent of targeted therapies and immunotherapies, said Mario Lacouture, MD, director of the Oncodermatology Program at Memorial Sloan Kettering Cancer Center. His research aims to provide patients the best possible quality of life while taking these treatments, which can often have adverse effects.

Research has shown that care provided through teledermatology is comparable to that delivered in face-to-face appointments, and future dermatologists are being taught to deliver care this way to improve patient access to expert dermatological care, said Nellie Konnikov, MD, professor and chief of dermatology at the Boston Department of Veterans Affairs.

Focus on behavioral interventions to prevent HIV transmission has been unsuccessful but the more recent intervention of using antiretroviral drugs has more promise, said Thomas C. Quinn, MD, director of the Johns Hopkins Center for Global Health.

A recent clinical trial found that SD-101, a new proprietary topical allantoin cream, can help treat epidermolysis bullosa (EB). The study is a breakthrough in EB treatment and research as treatment options for this rare and painful rare connective tissue disorder are limited.

Mohs surgery is generally the gold standard for rare and more aggressive tumors because the surgeon can ensure the roots of the tumor are gone, but the technique keeps the hole small, said Ally-Khan B. Somani, MD, PhD, at the 25th European Academy of Dermatology and Venereology Congress.

Plenary lecturer Stephen I. Katz, MD, PhD, director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, and adjunct investigator in the Dermatology Branch of the National Cancer Institute opened the 25th European Academy of Dermatology and Venereology Congress in Vienna, Austria, with a discussion on past and future advances in dermatology.

Reimbursement issues surrounding Mohs surgery are getting worse, which provides a challenge for surgeons who would perform the procedure, explained Aleksandar L. Krunic, MD, PhD, during the 25th European Academy of Dermatology and Venereology Congress.

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