Interviews

Leading up to the Supreme Court's decision in the case of King v. Burwell, Avik Roy, senior fellow at the Manhattan Institute, discusses in what ways Congress should potentially act if the plaintiffs receive a favorable ruling, who is to blame more if subsidies are removed from the federal marketplace, and how much time there will be for a patch to prevent millions of Americans losing financial assistance and subsequently their health insurance.

Bundled payments are the most manageable of all the Triple Aim models that focus on quality, improving patient experience, and total cost of care, according to Lili Brillstein, director of Episodes of Care at Horizon Blue Cross Blue Shield of New Jersey.

The US health industry is in the midst of a transformation to a value-outcome system, which is good for a learning health system, explained Lewis G. Sandy, MD, FACP, senior vice president of clinical advancement at UnitedHealth Group.

Most of the research in cancer economics has been on total cost and cost effectiveness, which is why Veena Shankaran MD, MS, assistant professor in the division of medical oncology at the University of Washington, wanted to have a panel discussion on financial toxicity at the ISPOR 20th Annual Meeting.

Aligning the care delivered with the patient's own desires is the biggest opportunity available to drive costs down while improving quality, according to Marc Boutin, JD, chief executive officer of the National Health Council.

With more than 35,000 people expected to attend the 2015 ASCO Annual Meeting, there are many highly anticipated aspects of the conference; however, Peter P. Yu, MD, FACP, FASCO, president of ASCO and director of Cancer Research at Palo Alto Medical Foundation, highlighted how the society has been going in a different direction with its keynote speaker.

The international representation and participation at the ISPOR 20th Annual Meeting was one of the key aspects of the meeting, held May 18-20 in Philadelphia, Pennsylvania, said Dan Malone, PhD, RPh, incoming president of ISPOR.

The new opioid quality measures by the Pharmacy Quality Alliance are a first step forward for improving use of prescription opioids.

The American Journal of Managed Care's Patient-Centered Oncology Care meeting is an important event for anyone interested in "crossing the chasm" that appears between providers and the rest of the healthcare world, explained Peter P. Yu, MD, president of the American Society of Clinical Oncology.

The industry has seen a lot of progress when it comes to involving patients more and earlier in the research progress, Dan Leonard, president of the National Pharmaceutical Council, said at the Pharmaceutical Quality Alliance's 10th Annual Meeting.

"Change happens at the speed of measurement," Troy Trygstad, PharmD, MBA, PhD, vice president of pharmacy programs at Community Care of North Carolina, said at the Pharmacy Quality Alliance 10th Annual Meeting.

The Maryland Health Connection, the state's insurance exchange, employed a number of strategies in during the second open enrollment period to get consumers signed up, explained Carolyn Quattrocki, executive director of the Maryland Health Benefit Exchange, the agency that operates Maryland Health Connection.

There are 3 general issues that cancer survivors face, and each of them are very different challenges, according to Crystal S. Denlinger, MD, from the Fox Chase Cancer Center in Philadelphia.

Costs have a huge impact on patients and financial toxicity, particularly in cancer care, is being given greater consideration now, according to Alex Bastian, MBA, senior vice president at GfK.

The medication adherence problem is emblematic of the larger coordinated care issue in the US healthcare system, according to Trishan Panch, MBBS, MPH, chief medical officer at Wellframe.

Given the diverse stakeholders in attendance, the hallway conversations at the ACO and Emerging Healthcare Delivery Coalition Spring 2015 meeting in San Diego, California, were just as interesting as the sessions, according to Anthony D. Slonim, MD, DrPH, president and chief executive officer for Renown Health, and co-chair of Coalition.

Although the Supreme Court oral arguments of King v. Burwell mostly went the way people were expecting, there were a few surprises, said Thomas P. Miller, JD, resident fellow at the American Enterprise Institute, who was able to sit in the courtroom the day of the arguments.

Having people from different parts of the diabetes care equation talking together at the 3rd Annual Patient-Centered Diabetes Care Meeting is what will move the industry forward, according to Robert A. Gabbay, MD, PhD, chief medical officer and senior vice president at Joslin Diabetes Center and the editor-in-chief of Evidence-Based Diabetes Management journal.

Evidence-Based Oncology is an important forum to have conversations that are needed in medicine today, said Joseph Alvarnas, MD, the new editor-in-chief of the journal.

Although Kentucky Gov Steve Beshear knew expanding Medicaid was the right thing to do, he had to make sure it the right economic choice for the state, too, he explained.

Medical research tends to be very segmented, but The American Journal of Managed Care (AJMC) has played an important role over the last 20 years in sharing new techniques and findings in managed care, said Margaret E. O'Kane, MHA, president of the National Committee on Quality Assurance.

The American Journal of Managed Care may be celebrating 20 years of publication, but Karen Ignagni, president and chief executive officer of America's Health Insurance Plans, is looking forward to many more.

Medicare Advantage has the potential to be the most powerful part of the solution for American healthcare, but the government needs to create reimbursement stability in order for that to happen, said Kent Thiry, chief executive officer of DaVita Healthcare Partners Inc.

The biggest problem with corporate wellness programs is that they are not as effective as they are claimed they will be, according Austin Frakt, PhD, health economist and researcher and the primary author of The Incidental Economist.

HHS Secretary Sylvia M. Burwell's announcement that CMS would move to value-based payments was a nail in the coffin for those skeptics who believed the push for value contracting would pass, according to Joseph Gifford, MD, chief executive of the Providence-Swedish Health Alliance.

On the 5th anniversary of the enactment of the Affordable Care Act, Susan Dentzer, senior policy advisor at the Robert Wood Johnson Foundaiton, looks back at what has been accomplished and looks ahead at what is left to do.

Over the past 20 years, The American Journal of Managed Care has been a great addition to the literature on advanced care models and innovation in healthcare systems, said David Blumenthal, MD, president of The Commonwealth Fund.

Although Republicans have been considering a repeal and replace approach to fixing the Affordable Care Act (ACA), Avik Roy, senior fellow at the Manhattan Institute, has his own plan.

Starting with a contract that works for both parties involved is the best way to ensure payers and providers will work together, said Craig Thiele, MD, chief medical officer of CareSource.

In order to really see quality improvement, it needs to be easier for physicians to access data and meet quality metrics, according to Lisa Hicks, MD, MSc.