Interviews

While it is likely that the Trump administration's proposed International Pricing Index would lower drug prices in the United States by at least a little, there are a number of potential unintended consequences that aren't clear at this point, said 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®.

Alison J. Moskowitz, MD, medical oncologist, clinical director, lymphoma inpatient unit, Memorial Sloan Kettering Cancer Center, discusses how the standard of care for Hodgkin lymphoma varies based on several different factors.

Janice Mehnert, MD, Head of the Phase I Developmental Therapeutics Program at Rutgers Cancer Institute of New Jersey, and the Head of the Melanoma Research Team, discusses the role that multiple biomarkers and the microbiome play in treatment decisions in oncology.

Having the Medicaid program value social determinants of health and the idea that health is not just about healthcare is important, said Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

Community health workers act as translators, have immense understanding of the makeup of the community and its needs, and are in-tune to feelings around certain healthcare and nonhealthcare-related topics, explained Victor Murray, director for care management initiatives at the Camden Coalition of Healthcare Providers.

There are so many different areas that a social worker can help with in a medical practice that they can be more a case manager, pointing patients to resources for financial assistance, looking at their insurance, or helping with disability, said Abra Kelson, MSW, LSWA-IC, medical social work supervisor, Northwest Medical Specialties.

Having more people in the doctor's office who speak Spanish and take time to explain what patients who don't speak any English are going through could help improve community health, said Maritza Gomez, program assistant for community engagement at the Camden Coalition of Healthcare Providers.

When data is allowed to flow freely, it can be used to understand the patient better and wrap a targeted intervention around them, explained Victor Murray, director for care management initiatives at the Camden Coalition of Healthcare Providers.

W. David Hardy, MD, adjunct professor of medicine, Johns Hopkins University, discusses the importance of identifying patients with undiagnosed HIV and preventing new infections for accomplishing President Trump's plan to end the HIV epidemic in 10 years.

Currently, minimal residual disease testing is being used for prognostication not for treatment decisions, explained Thomas G. Martin, MD, clinical professor of medicine, Adult Leukemia and Bone Marrow Transplantation Program, associate director, Myeloma Program, University of California, San Francisco (UCSF); co-leader, Hematopoietic Malignancies Program, Helen Diller Family Comprehensive Cancer Center.

Faith-based organizations teach members how to live a healthy lifestyle in ways that integrate with their faith, explained Maritza Gomez, program assistant for community engagement at the Camden Coalition of Healthcare Providers.

There are questions of hiring of staff, of leadership buy-in, of funding that all come into play when you are talking of how to scale a model beyond a single site, said Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

There are individuals who have a lot of needs and struggle to navigate different systems to get their needs met, and there are systems that don’t necessarily cooperate, partner, and collaborate in effective ways in order to address the needs of that cohort, said Victor Murray, director for care management initiatives at the Camden Coalition of Healthcare Providers.

The National Center is a place where experts come together, share their learning, redesign systems of care and develop practices and tools to support those who need it most, said Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

All providers, regardless of where they work have a role in the shift to value-based care, but independent physicians need to have a voice in the transition, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

The biggest barrier to molecular profile testing right now is a financial one, explained Elizabeth Griffiths, MD, associate professor of oncology, department of medicine, Roswell Park Comprehensive Cancer Center

Jeff Sharman, MD, medical oncologist, Willamette Valley Cancer Institute and Research Center; medical director, The US Oncology Network, explains how personalized medicine has changed the way physicians think about treatment for patients with chronic lymphocytic leukemia (CLL).

As the first clinically integrated oncology network, the Quality Cancer Care Alliance (QCCA) brings together the best practices and shares knowledge on value-based care, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

There needs to be a more trusting partnership between physicians and CMS and other payers that physicians want to deliver the best care to patients at a lower cost, said Barbara L. McAneny, MD, president of the AMA.

Elizabeth Griffiths, MD, associate professor of oncology, department of medicine, Roswell Park Comprehensive Cancer Center discusses which biomarkers and mutational events help determine if a patient would likely benefit from a traditional therapy or if they are more suitable for a clinical trial or upfront allogeneic transplantation.

The electronic medical record (EMR) can be burdensome but having a good value-based care team collecting data can help, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

As a physician, Brian Koffman, MDCM, DCFP, DABFM, MS Ed, medical director, CLL Society, was able to leverage his medical and scientific knowledge during treatment for his chronic lymphocytic leukemia (CLL), and he encourages other patients to educate themselves on their illnesses in order to receive the best care.

With a number of difference payment programs being tested, it’s important to have a sophisticated evaluation of these programs to really understand their impact on quality and cost, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

Elizabeth Griffiths, MD, associate professor of oncology, department of medicine, Roswell Park Comprehensive Cancer Center discusses recent approvals for acute myeloid leukemia (AML).

While all treatment regimens for Hodgkin lymphoma can cause neutropenia, the degree and the chance of neutropenic fever varies, explained Alison J. Moskowitz, MD, medical oncologist, clinical director, lymphoma inpatient unit, Memorial Sloan Kettering Cancer Center.

Results from the first 2 performance periods of the Oncology Care Model (OCM) highlighted areas where Northwest Medical Specialties was doing well and areas it could improve, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

With the low cost and high quality of community oncology practices and 40% of Americans living in rural areas, the country needs to preserve and allow community practices to thrive, said Barbara L. McAneny, MD, president of the American Medical Association and CEO of the New Mexico Cancer Center.

The Oncology Care Model (OCM) has been challenging for Texas Oncology as it has for all practices, said Lalan Wilfong, MD, executive vice president of Quality Programs at Texas Oncology.