Interviews

Robert Berenson, MD, FACP, Institue Fellow, Health Policy Center, Urban Institute, states that the development of new care delivery models will not happen overnight. There is time before expectations are put into specific quality metrics and regulations for models such as patient-centered medical homes and accountable care organizations.

Sara Rosenbaum, JD, Harold and Jane Hirsh Professor of Health Law and Policy and Founding Chair, Department of Health Policy, George Washington University School of Public Health and Health Services, says that the purpose of health reform was to provide people a source of affordable coverage so everyone would be attached to a payment system.

Peter Cunningham, PhD, Senior Fellow and Director of Quantitative Research, Center for Studying Health System Change, says that the expansion of people gaining coverage will be a big challenge for primary care delivery systems.

Robert Galvin, MD, CEO, Equity Healthcare, The BlackStone Group, states that bundling is a payment reform model that will allow for high quality and lowered costs.

Juliette Cubanski, PhD, Associate Director, Program on Medicare Policy, Kaiser Family Foundation, believes that the Medicare program overall has as much at stake in the 2012 election. Specifically, Dr. Cubanski says increasing private plan participation in Medicare and whether Medicare should move towards privatization will be some of the greatest challenges moving forward.

Karen Ignagni, President and Chief Executive Officer, AHIP, feels Medicare is right to take on the challenge of hospital readmissions. Ms. Ignagni also discusses how the Medicare Advantage plans have done a better job with traditional fee-for-services programs and tackling high hospital readmission rates.

Robert Berenson, MD, FACP, Institute Fellow, Health Policy Center, Urban Institute, thinks that new healthcare delivery models are inevitable due to the behavior of physicians and providers who have abused fee-for-service. Dr. Berenson says that there has been unacceptable growth in the bias of fee-for-service activities, and new delivery models are necessary to improve quality and costs in healthcare.

In this video, Aimee Tharaldson, PharmD, Senior Clinical Consultant, Emerging Therapeutics at Express Scripts, Inc, says that the increasing of specialty medication approvals impacts both patients and payers.

Mark Zitter, MBA, CEO of the Zitter Group, states that oncology pathways can standardize the way care is delivered while improving quality and reducing costs.

Debbie Stern, RPh, Vice President, Rxperts Inc, states that the utilization of prior authorizations, developing pathways, and relationships with specialty pharmacies all assist in the management of specialty pharmaceuticals.

Jeff Lemieux, Senior Vice President, Center for Health Policy and Research, AHIP, and Jon Bumbaugh, Director of Statistics & Actuarial Services, MedAssurant, Inc, address preventing hospital readmissions.

In this video, David Nau, PhD, RPh, CPHQ, Senior Director, Quality Strategies, Pharmacy Quality Alliance (PQA), speaks about the Electronic Quality Improvement Platform for Plans and Pharmacies (E-QuIPP). E-QuIPP will allow health plans and pharmacies to improve adherence and performance measurement.

Beckie Fenrick, PharmD, MDA, Senior Director, Medical Operations, Care Models and Affordability Solutions, Florida Blue, says that the trending increase in companion diagnostics allows for more personalized medicine.

Keith Dunleavy, MD, President and CEO, Inovalon, discusses the importance of comparative effectiveness research in order to improve chronic disease management at both the individual and population levels.

Barry Kinzbrunner, MD, Executive Vice President, Chief Medical Officer, VITAS Corporation, discusses the use of payment reform models to reduce hospital readmissions.

Sarah Thomas, Vice President, Public Policy and Communications, NCQA, says that this year the NCQA has a targeted interest in health insurance exchanges and delivery system reforms, such as accountable care organizations and patient-centered medical homes.

Robert Margolis, MD, Managing Partner and CEO, HealthCare Partners, says there needs to be a movement toward managing patients based on population.

Keith Dunleavy, MD, President and CEO, Inovalon, addresses the importance of healthcare data and the digitization of medicine. Dr. Dunleavy states that having quality data allows for more accurate care on an individual level, along with cost savings and a better risk score.

Barry Kinzbrunner, MD, Executive Vice President, Chief Medical Officer, VITAS Corporation, speaks about ways for managed care organizations to reduce hospital readmissions.

Sarah Thomas, Vice President, Public Policy and Communications, NCQA, says there are three options for states looking to initiate health insurance exchanges (HIX): federally facilitated, state sponsored, and partnership models.

Karen Ignagni, President and CEO, America's Health Insurance Plans (AHIP), states that higher costs and reductions in health plan options were consequences of states that did not link Affordable Care Act insurance market reforms and the individual mandate.

In this video, Mary Walsh, Member of the American College of Cardiology Board of Trustees and Chair of the organization's Patient-Centered Care Committee, talks about the efforts being made to truly individualize patient care and move away from a "one-size-fits-all" model in cardiology care.

James C. Capretta, MA, answers what process can be put in place for continual improvement in the productivity and quality of patient care.

Dr. Fenrick discusses the current and forthcoming trends in specialty pharmacy management.

In this video, Steve Marciniak, RPh, speaks of the challenges and value of specialty drugs.

Dr. Lewis addresses reasons why physicians have trouble when getting patients involved in decision making.

Cathleen Biga states that with a good amount of work and significant cost meaningful use can be achieved.

Dr. Nichols thinks a shared savings model without a straight fee cut could be a promising solution to the sustainable growth rate.

In this video, Dr. David Valle, speaks about how genetic variations impact patients' antibodies and immune systems in different ways. "We are beginning to gather the knowledge that is necessary to recognize the key individual differences that determine why patients behave in different ways, even though they have the same diagnostic label," says Valle.

Dr. Singh discusses CVS Caremark's strategies for managing oncology spending.