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Concerns Surrounding Enrollment into the Oncology Care Model
Michael Kolodziej, MD, suggests that payer concerns about the overall structure of the Oncology Care Model caused CMS to delay its letter of intent deadline. In this segment, the managed care stakeholders discuss why payers may be hesitant to apply for enrollment into the program.
Together, Dr Kolodziej; Brian Kiss, MD; and Ted Okon, MBA, comment that the model has great potential to transform the overall delivery of patient care but is far too prescriptive. Mr Okon remarks that the CMS is attempting to “dictate medicine.” However, he adds that despite these far-reaching recommendations, some practices are simply refusing to change their processes.
A variety of performance-based measures need to be evaluated under the Oncology Care Model, notes Dr Kolodziej. Despite reporting on all these different measures, he suggests that there are additional concerns about whether or not a physician will be reimbursed.
Dr Kolodziej also remarks that the model is structured to eliminate practices that have not demonstrated shared savings after 3 years, even though it supposedly considers savings over a 5-year period. Dr Kolodziej and Mr Okon comment that it is difficult for practices to demonstrate savings and increase income within this relatively short time frame.
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Data Back Neoadjuvant Combo vs Chemo Alone for Early-Stage NSCLC
April 24th 2024For patients with early-stage non–small cell lung cancer (NSCLC), combining neoadjuvant immune checkpoint inhibitors and platinum-based chemotherapy improves 2-year outcomes over chemotherapy alone, suggest findings of an extensive literature review and meta-analysis.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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The Federal Trade Commission's (FTC's) vote to ban most employers from issuing and enforcing noncompete clauses could have varying impacts on the health care workforce; federal regulators vastly under-enforced antitrust laws in the hospital sector during the last 2 decades, resulting in increased health costs; the FDA recently found genetic evidence of the H5N1 bird flu virus in pasteurized commercially purchased milk.
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Polatuzumab Vedotin and R-CHP Appropriate for Untreated DLBCL
April 24th 2024Population pharmacokinetic and exposure-response analyses revealed a favorable benefit-risk profilane for the treatment combination of polatuzumab vedotin and rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP).
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