Oncology

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It is well known that oncology care pathways are the tools that practices can utilize to care for its patients. Ira Klein, MD, MBA, FACP, chief medical officer, National Accounts Clinical Sales & Strategy, Aetna, suggests that Aetna's only involvement in creating these pathways should be in helping these practices develop "reasonable care pathways."

One insurer's experimental reimbursement model proved to lower the total costs of care for patients with 3 types of cancer. As an alternative to the traditional fee-for-service payment model, the episode payment model-which reimburses physicians on a fixed-price, based on episodes of best-practices and patient outcomes-provided encouraging findings in the battle against the rising costs of cancer care in the United States.

There has been a sharp increase in the number of cancer patients at one hospital using MyChart, the online, interactive service that allows patients to view laboratory and radiology results, communicate with their healthcare providers, and more.

This week, a coalition of 32 major pharmacies, health insurers, unions and pension plans asked the FDA not to require distinct names for biosimilar medications, arguing that such a move would not compromise patient safety, but could undermine the savings that are expected to be generated as these medicines are introduced into the US health care system.

Clinical care pathways in oncology have gained notice with WellPoint's announcement of a $350 per patient, per month incentive. As WellPoint's effort starts this week, The American Journal of Managed Care convened a panel with the insurer's medical director for oncology care, ASCO President Peter Paul Yu, MD, and two other voices from the payer and provider realms to discuss how pathways are changing cancer care.

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