Interviews

Brian Marcotte, president and CEO of the National Business Group on Health, offers recommendations for employers that are considering accountable care organizations (ACOs) and describes situations when an ACO is not a good fit.

Very structured processes for vendor selection is necessary to improve outcome measurements and data analytics, explained Aaron Lyss, director of value-based care for Tennessee Oncology.

Cost will be one of the most important factors to determine whether or not a biosimilar pegfilgrastim improves patient access to the treatment, said Leora Horn, MD, clinical director of thoracic oncology at Vanderbilt-Ingraham Cancer Center, assistant vice chancellor for faculty development at Vanderbilt University Medical Center.

Value-based care will start to transition from being an option to being a requirement, and better data will be needed to improve how care is delivered to patients, said Kim Woofter, executive vice president of strategic alliances and practice innovation at the Advanced Centers for Cancer Care.

Compared with the trial results of EUCLID and PEGASUS, the COMPASS trial advances the field of cardiovascular disease in combination therapies, said John Eikelboom, MD, of McMaster University.

As the healthcare industry tries to move away from fee-for-service, the new Scorecard being developed by Catalyst for Payment Reform will help states get a better understanding of whether or not new payment models are actually working, explained Linda Schwimmer, CEO and president of the New Jersey Health Care Quality Institute.

Charlie Fazio, MD, senior vice president and medical director of HealthPartners discusses the uncertainty felt by practices as the industry moves from fee-for-service to value-based care.

Naiyer A. Rizvi, MD, director of thoracic oncology and immunotherapeutics at Columbia University Medical Center discusses the effectiveness of PD-1 antibodies in lung cancer.

Getting people on board when a new electronic health record (EHR) is being implemented is one of the biggest obstacles to overcome and is important for the success of the new EHR, said Teri Kovach, RN, OCN, compliance officer and charge nurse at Salish Cancer Center.

Technological advances will lead to improvements in clinical trials and greater participation in trials by patients, explained Michael Kolodziej, MD, national medical director of managed care strategy at Flatiron Health.

Payers and other organizations can help smaller practices develop the necessary infrastructure to complete their healthcare transformation, said Peter Aran, MD, medical director of population health management at Blue Cross Blue Shield of Oklahoma.

As the health system evolves it will become increasingly important that practices understand business, explained Tesh Khullar, senior vice president of provider solutions at Flatiron Health.

CMS’ decision to exclude digital health from its proposal for the Medicare Diabetes Prevention Program (DPP) has caused a controversy, explained Paul Chew, MD, chief medical officer of Omada Health.

There are 2 categories of challenges facing oncology practices as they transition to value-based payment models, said Aaron Lyss, director of value-based care for Tennessee Oncology.

Creating outside partnerships for community oncology practices is important because these partnerships move the industry towards value-based payment models, said Kim Woofter, executive vice president of strategic alliances and practice innovation at the Advanced Centers for Cancer Care.

Drug pricing is one area where there may be potential future policy changes that impact community oncologists, said Dan Todd, JD, principal at Todd Strategy.

Employers have started to focus on fulfilling opportunities to control costs and supplying more services to help employees understand their treatment options and the healthcare system as a whole, explained Brian Marcotte, president and CEO of the National Business Group on Health.

As clinical trials get more complex and fewer patients are available to participate in any particular trial, technology is going to be critical for improving patient access to trials and making the whole process of being on a trial easier for patients and physicians, explained Amy Abernethy, MD, PhD, the chief medical officer, chief scientific officer, and senior vice president of oncology at Flatiron Health.

OCM provides tools and resources to not only help patients, but also support clinical staff with continuous education and training. Nurse Weaver describes the benefits and rewards of functioning as a team towards a common goal.

Does OCM require major changes to your practice to achieve this wholistic approach? Watch to find out what is needed to practice the “OCM Way”.

Implementation of OCM does not have to be a burden. Dr. Gor explains the implementation of OCM, potential cost savings and utilization with non-oncology patients.

Dr. Patel explains the metrics tracked at Carolina Blood and Cancer Care and identifies how these informed their understanding of patient care.

OCM provides focus on individual patient cases. Learn how OCM affects the interaction between healthcare professional and patient.

Lee N. Newcomer, MD, MHA, senior vice president of oncology and genetics at UnitedHealthcare, discusses the partnership that is established with the implementation of episode-based payments, because now the physicians and other stakeholders have the same goal.

While the healthcare industry moves more toward value-based payment models, oncology practices are at a disadvantage because few payers truly understand the nuances of cancer care to design good oncology payment models, explained Aaron Lyss, director of value-based care for Tennessee Oncology.

Success in primary care should be based on how efficient and effective the physician is caring for the patient, and how satisfied the patient is with his or her care, rather than how many patients a physician is seeing in a day, said Charlie Fazio, MD, senior vice president and medical director of HealthPartners.

With 35% of Americans having prediabetes, prevention is clearly a priority, but many strategies have not bee translated into clinical practice because there is no system for reimbursement yet, explained Paul Chew, MD, chief medical officer of Omada Health

Flatiron Health focuses on helping community oncologists because they still care for the majority of patients with cancer and make it possible for patients to get care without traveling long distances, explained Nat Turner, co-founder and CEO of Flatiron Health.

While the ongoing healthcare debate in Congress creating a lot of uncertainty among the healthcare industry, there are areas of certainty and optimism, said Dan Todd, JD, principal at Todd Strategy.

Despite the politics involved in healthcare, it seems unlikely that the industry to going to stop its migration toward more accountability for quality, said Michael Kolodziej, MD, national medical director of managed care strategy at Flatiron Health.