Segment 1 - Patient-Centered Care and Shared Decisions in Oncology

Joseph Alvarnas, MD, editor-in-chief of Evidence-Based-OncologyTM spoke with Rebekkah Schear, MIA, and Michael Kolodziej, MD, to discuss the progress and challenges in oncology care.

To discuss this progress and what is currently lacking in care practices in oncology, The American Journal of Managed Care® invited Rebekkah Schear, MIA, director of mission delivery at the LIVESTRONG Foundation, and Michael Kolodziej, MD, former national medical director of oncology strategies at Aetna and currently the national medical director of Managed Care Strategy at Flatiron Health. The telepanel was moderated by Joseph Alvarnas, MD, editor-in-chief of Evidence-Based-OncologyTM. Alvarnas is associate clinical professor and director of medical quality, risk, and regulatory management, City of Hope, Duarte, California.

The panel began with Alvarnas asking each participant to define what patient-centeredness and shared decision making mean in oncology care. "There's a lot that I think I can articulate when we talk about how patients and families can be engaged in discussions on treatment planning," Schear said. "But really what I think we're seeing in terms of paradigm shift around oncology in particular, is that patient-centeredness is becoming the new paradigm for how care is to be delivered."

Kolodziej explained that oncologists believe they are doing a perfectly fine job in educating patients and including them in treatment decisions. Payers, on the other hand, do not have much insight into how well this is being implemented by oncologists, but he agreed with Schear that there are shortcomings to the process. “The biggest shortcoming really boils down to the fact that when a newly-diagnosed patient comes into your office with, or without, supportive family members or friends, there is just such a knowledge gradient and it’s such a loaded conversation. It’s very hard to process it,” Kolodziej said.

Kolodziej believes that the provisions within payment models such as the Oncology Care Model can help provide patients access to their treatment plan.

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