Oncology

To speak about the success and continued development of Priority Health's payment reform model in cancer care, John Fox, MD, medical director at Priority Health, joined Dennis Zoet, chief business development officer at Cancer and Hematology Centers of Western Michigan, on a panel at the Community Oncology Alliance Payer Exchange Summit.

Heloisa Soares, MD, assistant professor, University of New Mexico Cancer Center-Albuquerque, outlines current barriers to achieving positive outcomes in neuroendocrine tumors (NETs) and what's in store for the future.

I’ve seen one case recently where a patient received $172,000 of drugs that were totally wasted. So, we’re going to be looking at this, we’re going to be looking at these middlemen getting in the way of the patient and the physician making a decision about their therapy, explained Ted Okon, executive director of COA.

Looking at total cost of care is difficult and figuring out what the practice is responsible for and not responsible for can be very difficult to do, said Lalan Wilfong, MD, executive vice president of Quality Programs at Texas Oncology.

A patient has their own set of values, providers have their own set of values, and the people that pay for it have their own set of values. So, [we all need to] come together, explains Bo Gamble, Director Of Strategic Practice Initiatives at the Community Oncology Alliance.

At the Community Oncology Alliance Payer Exchange Summit, healthcare policy experts from a government relations firm and from the pharmaceutical industry provided an update on the progress with value-based agreements and also discussed the challenges posed by the existing infrastructure and operational framework.

In the last decade, testing for and treatment of chronic lymphocytic leukemia (CLL) had undergone substantial changes with new testing that can personalize therapy and new agents that provide more clinical benefit.

The Community Oncology Alliance (COA) has been working with its member practices and some payer partners who have successfully implemented innovative care delivery and payment models to develop a 2.0 version of CMS’ Oncology Care Model (OCM). A progress report was presented at COA’s Payer Exchange Summit held October 29-30 in Tyson’s Corner, Virginia.

While practice transformation is vital, community-based clinics continue to struggle with emergency department (ED) use, hospitalization, and risk stratification as they identify ways to reduce unnecessary expenditures within their Oncology Care Model (OCM) practice.

Lalan Wilfong, MD, moderated a conversation between Robert E. Baird, MD, CEO of Dayton Physicians Network, and Sarah Cevallos, chief revenue cycle officer for Florida Cancer Specialists and Research Institute, about current and future strategies for Oncology Care Model (OCM) participation, as well as key lessons from the OCM and how they can be applied in other reform models.

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.

This week, the top managed care news included the Trump administration giving governors the power to overhaul section 1332 waivers under the Affordable Care Act (ACA); CMS disclosed a breach in the portal that agents and brokers use to assist consumers signing up for health coverage under the ACA; about one-third of all US healthcare payments in 2017 were tied to alternative payment models.

A recent trial sought to assess the effect of palbociclib on overall survival (OS) and the efficacy of subsequent therapy in patients with hormone receptor–positive (HR+), HER2-negative advanced breast cancer.

According to a study presented at the ESMO 2018 Congress in Munich, Germany, treatment with PD-1 or PD-L1 inhibitors is a feasible option for patients who have cancer and are living with HIV.

A survivor of chronic lymphocytic leukemia who participated in the first chimeric antigen receptor T-cell trial in 2010 looks back at his experience and also discusses his views on how patient-reported outcomes (PROs) should be used, if at all, by CMS.

A phase 3 trial recently investigated if nanoparticle albumin-bound paclitaxel enhances the treatment of atezolizumab in unresectable locally advanced or metastatic triple-negative breast cancer.

It’s fair to say that the initial results of immunotherapy in neuroendocrine tumors (NETs) have been somewhat disappointing, explained Thorvardur Halfdanarson, MD, associate professor of medicine and consultant in medical oncology, Mayo Clinic.

Accountable care organizations (ACOs) in the Medicare Shared Savings Program vary considerably in how they treat men with newly diagnosed prostate cancer, according to a study that assessed whether the level of engagement in ACOs by urologists could affect rates of treatment, overtreatment, and spending in prostate cancer care.

The EVI1 gene may be single-handedly at fault for acute myeloid leukemia, according to research published in Nature Communications.

A recent study looked to use real-world data to support the value of pathway regimens designed to create high-quality, affordable treatment in breast cancer care.

AJMC®TV interviews let you catch up on what’s new and important about changes in healthcare, with insights from key decision makers—from the clinician, to the health plan leader, to the regulator. When every minute in your day matters,AJMC®TV interviews keep you informed. Access the video clips at ajmc.com/interviews.

“Every great magic trick consists of three parts or acts. The first part is called ‘The Pledge.’ The magician shows you something ordinary. ...The second act is called ‘The Turn.’ The magician takes the ordinary something and makes it do something extraordinary. Now you’re looking for the secret, but you won’t find it, because of course you’re not really looking...Every magic trick has a third act, the hardest part, the part we call ‘The Prestige.’” — Christopher Priest, The Prestige

Switchable chimeric antigen receptor (CAR) T cells with a switch directed towards human epidermal growth factor receptor 2 (HER2) in pancreatic ductal adenocarcinoma (PDAC) has similar efficacy as conventional HER2 CAR T cells while also having a greater control over treatment toxicities.

Scott Paulson, MD, co-director of the Gastrointestinal Research Program for The US Oncology Network, medical director for the Neuroendocrine Research and Treatment Center at Baylor Charles A. Sammons Cancer Center, Baylor University Medical Center, explains the current standard of treatment and novel approaches being taken in gastroenteropancreatic neuroendocrine tumors (GEP-NETs).