Interviews

Stephen Grubbs, MD, vice president of clinical affairs at the American Society of Clinical Oncology, explains what stakeholders can expect from the new updates to the Patient-Centered Oncology Payment (PCOP) model, as well as some key differences between PCOP and the Oncology Care Model.

We need to find someone who’s doing very strong, rigorous research and then we need to find someone who’s doing work on really important topics, says Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy; director of the Healthcare Markets and Regulation Lab in the Department of Health Care Policy at Harvard Medical School; and co-editor-in-chief of The American Journal of Managed Care®.

Blase Polite, MD, associate professor of medicine and the executive director for accountable care at the University of Chicago, discusses why he chose to focus on the state of the Oncology Care Model at the April 25 meeting of the Institute for Value-Based Medicine.

As we move away from a system of external development grants that help us maintain our HIV models to a system where our returns on investment support the work that we do, there’s a concern that there will be some slimming down of services that get patients in to our practice, explained Stella A. Safo, MD, assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai.

Payers, providers, and other stakeholders have to come together to figure out how to make a better patient member experience for those who are fighting cancer, said Bryan Loy, MD, physician lead, oncology, laboratory, and personalized medicine, Humana.

After the first 2 performance periods of the Oncology Care Model, it became clear hospice care was an area where Northwest Medical Specialties could improve, and care coordinators could help, said Jessa Dunivan, patient services manager, Northwest Medical Specialties.

Having a care management team in place builds trust with patients so they are caught before something really serious happens that sends them to the emergency department, said Beth Wittmer, RN, OCN, manager of care management at Florida Cancer Specialists and Research Institute.

The standard treatment isn’t always right for everyone, and part of a social worker’s job as a member of the care team is to understand the patient’s goals and what treatment is the right fit for them, said Abra Kelson, MSW, LSWA-IC, medical social work supervisor, Northwest Medical Specialties.

Awards need to also recognize researchers whose work has an impact on policy and can be translated for policy makers and even the broader public to understand, said Dana Goldman, PhD, the Leonard D. Schaeffer Chair and director of the USC Leonard D. Schaeffer Center for Health Policy and Economics and Professor of Public Policy, Pharmacy, and Economics at the USC Sol Price School of Public Policy and USC School of Pharmacy.

Howard A. "Skip" Burris, III, MD, FACP, FASCO, president, clinical operations, and chief medical officer of Sarah Cannon Research Institute, discusses differentiating which patients will benefit from next-generation sequencing (NGS) and the role of NGS testing for matching patients to clinical trials.

Implementing new payment models is really complicated, and the private sector is not doing as much as the public sector, said Michael Kolodziej, MD, vice president and chief innovation officer at ADVI Health, Inc.

Taking care of a patient in the shift to value-based care means utilizing care managers to answer questions when the physician isn’t available, says Beth Wittmer, RN, OCN, manager of care management at Florida Cancer Specialists and Research Institute.

With all the regulatory changes that CMS and HHS are rolling out, community oncology practices are facing significant changes in how they take care of patients, said Barry Russo, chief executive officer of The Center for Cancer and Blood Disorders.

Sex differences in multiple sclerosis (MS) has been known for some time, and studying these differences benefit both sexes, explained Rhonda Voskuhl, MD, Jack H. Skirball chair of MS research, director of the MS program, and professor of neurology at the University of California, Los Angeles.

The core of the work that care coordinators do is done behind the scenes so that all of the core information is in the chart when the doctor is meeting with the patient, said Jessa Dunivan, patient services manager, Northwest Medical Specialties.

Using oncology care pathways and treatment pathways has helped practices use evidence-based data to facilitate them to be sure they are using the right drug for the right patient at the right time, said Ray Page, DO, PhD, president and director of research at The Center for Cancer and Blood Disorders.

There are disparities in access to innovative therapies and entries into clinical trials, but FDA's recent proposed guidance could help close gaps, said John W. Sweetenham, MD, senior director of clinical affairs and executive medical director, Huntsman Cancer Institute at the University of Utah.

Most academic journals are researchers talking to researchers, butThe American Journal of Managed Care® (AJMC®) is typically researchers talking to the community, says Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy; director of the Healthcare Markets and Regulation Lab in the Department of Health Care Policy at Harvard Medical School; and co-editor-in-chief of AJMC®.

Utilizing community resources is an important way to help patients who have poor social support systems get the care they need, said Abra Kelson, MSW, LSWA-IC, medical social work supervisor, Northwest Medical Specialties.

Through partnerships, CancerIQ tries to reduce barriers for patients to use genetic services to detect cancer early, said Feyi Olopade Ayodele, MBA, chief executive officer at CancerIQ.

Community oncology practices need to come together as much as possible in order to respond to changes in the market, have a common voice, and to share best practices and learn from each other, said Barry Russo, chief executive officer of The Center for Cancer and Blood Disorders.

The care team is made up of a number of members, who work together to uncover and then address any barriers that patients have, said Jessa Dunivan, patient services manager, Northwest Medical Specialties.

As clinicians learn how to manage patients most efficiently under a value-based care of delivery, they need to identify patients and risk-stratify those patients, said Ray Page, DO, PhD, president and director of research at The Center for Cancer and Blood Disorders.

There are 2 approaches for treating multiple sclerosis (MS) and the DELIVER-MS study is the first to see which approach works better, said Daniel Ontaneda, MD, a neurologist at the Cleveland Clinic.

Employees have seen their healthcare costs rise about as much as they can, and the employers have also taken on about as much burden as they can, so now they’re looking at things that they can do and strategies that they can take to make sure that they’re providing the right benefits to the right people, says Dave Fried, chief executive officer of Tricore Human Capital Management.

Wayne Burton, MD, former global corporate medical director for American Express discusses the impact that workers with migraine have on employers.

Early intervention to identify social needs means issues get caught sooner and patients can avoid or minimize financial toxicity, said Abra Kelson, MSW, LSWA-IC, medical social work supervisor, Northwest Medical Specialties.

The challenge with translating good science into treatments for patients with multiple sclerosis (MS) is getting the funding to get the trials done, said Rhonda Voskuhl, MD, Jack H. Skirball chair of multiple sclerosis (MS) research, director of the MS program, and professor of neurology at the University of California, Los Angeles (UCLA).