Interviews

The Putting Care at the Center meeting, being held December 5-7 in Chicago, Illinois, is the only meeting solely dedicated to sharing best learnings about delivering care to patients with complex health and social needs. People who attend the meeting will be able to meet others from around the country who are putting plans into action and attend panel discussions and workshops, explained Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

Practices that had experience with the COME HOME community oncology medical home model didn’t perform any better in the Oncology Care Model (OCM) than other practices, explained Barbara L. McAneny, MD, president of the American Medical Association.

In 2015, NCCN introduced the NCCN evidence blocks which is a tool that allowed for clinicians and patients to have a conversation about what is important to a patient’s individual value system, said Lyn Fitzgerald, senior vice president of US & Global Development at NCCN.

There are more similarities between patients with opioid dependency and patients with opioid misuse and abuse than physicians have been led to believe, said Elizabeth Stringer, PhD, chief science and clinical officer of axialHealthcare.

The Project ECHO program helps make local community providers into experts in specialty areas in order to improve access to care for their patients, explained Sanjeev Arora, MD, FACG, MACP, director and founder of Project ECHO and a professor of medicine at University of New Mexico.

As healthcare becomes an increasingly important issue in society, it’s necessary for researchers to be able to produce work that is digestible for broad audiences, which is something Erin Trish, PhD, an assistant research professor at the University of Southern California (USC) Price School of Public Policy and associate director of health policy at the USC Schaeffer Center, excels at, explained 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.

The practices in the Quality Cancer Care Alliance (QCCA) are able to share data to improve the quality of cancer care delivered to patients, explained Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

The American Medical Association (AMA) has concerns with the proposed changes CMS is looking to make to the Medicare accountable care organization (ACO) program and with the announced change to allow step therapy in Medicare Advantage plans, explained Barbara L. McAneny, MD, president of the AMA.

It has been good knowing that treatments he has had a hand in developing will give years of quality life to patients, where treatments only gave a few months before, explained James Allison, PhD, chair of the Department of Immunology, the Vivian L. Smith Distinguished Chair in Immunology, director of the Parker Institute for Cancer Research, executive director of the Immunotherapy Platform at MD Anderson Cancer Center, and 2018 Nobel Prize cowinner in Medicine.

The American Medical Association (AMA) had pushed for the CVS–Aetna merger to be blocked because of the increasing body of literature that shows consolidation results in more expensive care with no increase in quality, said Barbara L. McAneny, MD, president of the AMA.

Project ECHO, which helps specialists disseminate knowledge to primary care providers, was created on the idea that patients should not be dying from curable diseases because they don’t have access to the right providers, said Sanjeev Arora, MD, FACG, MACP, director and founder of Project ECHO and a professor of medicine at University of New Mexico.

As a basic scientist, James Allison, PhD, didn’t always meet the patients who benefitted from treatments he discovered, but he did meet 1 woman who participated in one of the early trials of ipilimumab.

Practices that did not meet cost-savings goals in either the first or second performance periods of the Oncology Care Model (OCM) will likely leave the program, said Barbara L. McAneny, MD, president of the American Medical Association.

Major discoveries only happen when there is funding for fundamental science, said James Allison, PhD, chair of the Department of Immunology, the Vivian L. Smith Distinguished Chair in Immunology, director of the Parker Institute for Cancer Research, executive director of the Immunotherapy Platform at MD Anderson Cancer Center, and 2018 Nobel Prize cowinner in Medicine. He explained that he never would have discovered how to use the CTLA-4 protein to treat cancer if he hadn’t been trying to understand the mechanisms of T-cell activation.

Chronic pain is often associated with depression or dysphoria as people can no longer do all the things they want, which may require psychosocial services, said Winston Collins, PhD, program director for substance use services at the John F. Kennedy Behavioral Health Centers.

Healthcare providers must think about the entire home environment their patient lives in when prescribing opioids, said Jeffrey Gudin, MD, director of Pain Management and Palliative Care at Englewood Hospital and Medical Center.

There are a growing number of diabetes therapies, which has led to the need to individualize choices based on patient profile, said Robert A. Gabbay, MD, PhD, FACP, senior vice president and chief medical officer of Joslin Diabetes Center.

Getting more patients access to medication-assisted treatment for their substance use disorder requires reducing the stigma of the disease, said Winston Collins, PhD, program director for substance use services at the John F. Kennedy Behavioral Health Centers.

Assessing a patient’s understanding of his or her own illness is important as cancer treatments become more and more complex, said Denalee O’Malley, PhD, LSW, instructor, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School.

There are 2 ways prescription drug monitoring programs can improve, said Jeffrey Gudin, MD, Pain Management and Palliative Care at Englewood Hospital and Medical Center.

There are medications, procedures, and techniques that insurers could do a better job covering that would improve quality for women after breast cancer, said Don S. Dizon, MD, FACP, FASCO, director of Women's Cancers at the Lifespan Cancer Institute, director of medical oncology at Rhode Island Hospital, and associate professor of medicine at The Warren Alpert Medical School of Brown University.

Health systems will need to be able to provide multiple services to treat and support people recovering from substance use disorder, which requires interaction and communication, said Winston Collins, PhD, program director for substance use services at the John F. Kennedy Behavioral Health Centers.

Making financial sacrifices during treatment can have long-term effects on survivorship for patients with cancer, said Denalee O’Malley, PhD, LSW, instructor, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School.

The pendulum has swung so far that even patients with cancer pain may not get the appropriate medications they need, but there are things healthcare providers can keep in mind when caring for patients who need opioids for pain, said Jeffrey Gudin, MD, director of Pain Management and Palliative Care at Englewood Hospital and Medical Center.

Most oncologists aren’t comfortable discussing sexual health needs with their patients, but there are places where sexual health services for patients with cancer are starting to gain foothold, said Don S. Dizon, MD, FACP, FASCO, director of Women's Cancers at the Lifespan Cancer Institute, director of medical oncology at Rhode Island Hospital, and associate professor of medicine at The Warren Alpert Medical School of Brown University.

Younger, premenopausal patients with breast cancer can have unique issues that providers need to keep in mind, said Denalee O’Malley, PhD, LSW, instructor, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School.

Robert A. Gabbay, MD, PhD, FACP, senior vice president and chief medical officer of Joslin Diabetes Center, explains why the Joslin Diabetes Center and the American Diabetes Association oppose the decision by the American College of Physicians to recommend a higher A1C target across the board.

The Joslin Clinical Guidelines are designed to be streamlined and disseminated as widely as possible, explained Robert A. Gabbay, MD, PhD, FACP, senior vice president and chief medical officer of Joslin Diabetes Center.