Value-Based Care

Robert Groves, MD, of Banner | Aetna discusses the challenges primary care practitioners (PCPs) face when addressing social determinants of health (SDOH).

Patients seen at value-based care clinics received more preventive screenings and had lower risks of hospitalization and emergency room visits, according to Humana’s 10th annual value-based care report.

Michael Yim, MD, board-certified family physician, discussed the need for and logistics of collaboration between oncologists and primary care providers.

In an interview with The American Journal of Managed Care®, Grant Andres, BSc, DC, BSN, MSN-RN, senior director of clinical operations at Arizona Oncology, discussed the nuances of successfully implementing value-based care initiatives across a large organization.

Amitkumar Mehta, MD, MBA, University of Alabama at Birmingham, notes the long-term data and potential curative effects of chimeric antigen receptor (CAR) T-cell therapy, while expressing optimism about bispecific therapy with ongoing evolution and the chance of significant patient responses.

Edward "Ted" Arrowsmith, MD, MPH, medical director for pathways at OneOncology and managing partner at Tennessee Oncology, highlights the need for trust between payers and providers, as well as finding balance in building consistent clinical pathways while prioritizing specific practice needs.

Investigators propose potential payment models for gene therapies that consider equitable patient access and payer reimbursement.

There is a lot of noise in the health care system, and oncologists need to collaborate and decide on common shared goals, said Lucy Langer, MD, MSHS, national medical director of oncology and genomics at UnitedHealthcare.

Leveraging technology intelligently can make the patient-doctor interaction much more seamless and connected, said Samyukta Mullangi, MD, MBA, medical director of oncology at Thyme Care, medical oncologist at Tennessee Oncology.

This 2022 survey of Medicare accountable care organizations (ACOs) shows significant growth in non-Medicare value-based contracts and in contracts with downside risk.

The Enhancing Oncology Model is trying to address a number of the systemic challenges oncology faces without giving practices the tools and resources they need, said Nicolas Ferreyros, managing director of policy, advocacy, and communications, Community Oncology Alliance.

Sophia Humphreys, PharmD, MHA, BCBBS, discusses highlights of the Institute for Value-Based Medicine® (IVBM) event, held in partnership with Providence Health System, that recently took place in Newport Beach, California.

Federal actuaries have projected what they believe to be health care spending through 2030-2031 in 9 important areas.

Through the integration of a population health reimbursement model in 2020, Allina Health Cancer Institute was able to implement expanded screening initiatives through the use of artificial intelligence and precision medicine, according to Mike Koroscik, MBA, MHA, vice president of oncology, Allina Health.

Melissa Levine, MD, a family medicine specialist at Arizona Community Physicians and medical director for the Abacus Health accountable care organization (ACO), discussed strategies for succeeding in an ACO and how primary care can complement oncology care for patients with cancer.

At the 2023 COA Payer Exchange Summit being held October 23-24 in Reston, Virginia, Lalan Wilfong, MD, US Oncology Network, emphasizes the importance of oncology care equity, ensuring continuity of care, and enhancing care coordination.

This analysis demonstrates value and innovation of direct-acting antivirals for the treatment of chronic hepatitis C in the US Kaiser Permanente health system.

Kristine Slam, MD, FACP, Central Ohio Surgical Associates, addresses the importance of involving patients in decisions regarding their goals for treatment, emphasizing that this involvement is critical to uncover what they value, as well as their short- and long-term goals for treatment.

Alma Habib, MD, The Ohio State University Comprehensive Cancer Center, talks about the fact that disparities are able to be recognized in leukemia/lymphoma care, but the questions of how to address these disparities remain.

Jennifer Vaughn, MD, discusses how value-based care in hematology should consider cost and financial toxicity, as well as valuable patient experience.

Sarah Wall, MD, talks about how it’s important to consider patient age when treating older patients with cancer because it will impact so many of them and blood cancers act differently and can be more aggressive in older adults.

Sarah Boyce, president and CEO at Avidity Biosciences, discusses her leading role at the company, as well as antibody oligonucleotide conjugate drug, AOC 1044, currently in development for Duchenne muscular dystrophy (DMD) with mutations amenable to exon 44 skipping (DMD44).

Rajini Katipamula-Malisetti, MD, executive vice president of Minnesota Oncology, defined value-based cancer care and its importance.

A presentation at the Association of Community Cancer Centers’ 40th National Oncology Conference explored how a cancer screening initiative can be sustainable and revenue positive while driving value-based savings in an evolving market.

Rhonda Henschel, US Oncology Network's vice president of payer relations, summarized what she learned from the Minnesota Oncology IVBM and discussed new developments in the value-based cancer care space.

Jennifer Sturgill, DO, Central Ohio Primary Care, discusses how shortages of antibiotics and medications for attention-deficit/hyperactivity disorder have affected primary care, as well as addresses the impact on heart failure care of CMS’ recent announcement of the first 10 drugs up for price negotiation in 2026 under the Inflation Reduction Act (IRA).

Olalekan Ajayi, PharmD, MBA, 2023-2024 president of the Association of Community Cancer Centers (ACCC) and chief operating officer of Highlands Oncology Group, PA, reflects upon his role at ACCC and highlights key topics in oncology care and cancer research that will be presented at the National Oncology Conference.

Fee-for-service care is not really in line with how primary care physicians think or how primary care should be delivered; the crux of value-based care is wanting patients to have the care they want and need, noted Kristin Oaks, DO, Agilon regional medical director at Central Ohio Primary Care.

This year’s 40th National Oncology Conference from the Association of Community Cancer Centers (ACCC) will take place in Austin, Texas, from October 4-6, with content designed to reflect the theme of “Reimagining Innovation.”

In this interview from our recent Institute for Value-Based Medicine® event, Kristine Slam, MD, FACP, Central Ohio Surgical Associates, discusses the positive impact that Choosing Wisely and enhanced recovery after surgery, or EROS, protocols have had on patients receiving treatment for breast cancer.