Interviews

Offering patients genetic counseling before and after they receive genetic testing is crucial for making sure they understand what the results mean, explained John Fox, MD, MHA, vice president of Clinical Transformation at Spectrum Health.

The cost of radiation oncology services has typically been a small part of the Medicare and Medicaid budget, but with more patients having complex radiation treatments, it is becoming more important to have alternative payment models in the space, said Shalom Kalnicki, MD, FASTRO, FACRO, professor and chairman, radiation oncology, Montefiore Einstein Center for Cancer Care and Albert Einstein College of Medicine.

Albert Rizzo, MD, FACP, chief medical officer for the American Lung Association, offers his thoughts on the FDA's recent proposal to require health warnings with images on cigarette packages.

Monoclonal gammopathy of undetermined significance is a diagnosis of exclusion, but even once it has been identified, patients should not obsess over this precancerous condition, said Ajai Chari, MD, associate professor of medicine, Hematology and Medical Oncology, Mount Sinai Hospital.

With an increase in the use of 3- and 4-drug regimens in multiple myeloma, providers are going to need to communicate the out-of-pocket costs when presenting treatment options so that patients can make an informed decision, explained John Fox, MD, MHA, vice president of Clinical Transformation at Spectrum Health.

Ahmar Zaidi, MD, pediatric hematologist-oncologist, Comprehensive Sickle Cell Center, Children's Hospital of Michigan, discusses the need for more efforts from both the medical community and regulators to address the psychosocial complications of sickle cell disease.

Employers are looking for ways to advocate for their employees and invest in places that will reduce downstream costs, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.

Understanding patient-reported outcomes in disease states enhances our ability to provide patients with better care and an increased quality of life, said Patty Taddei-Allen, PharmD, MBA, BCACP, BCGP, director of outcomes research, WelldyneRx.

Iuliana Shapira, MD, chief medical officer, Regional Cancer Care Associates (RCCA), discusses how RCCA is managing the higher costs of immuno-oncology drugs in value-based care.

Jeroen Jansen, PhD, lead scientific advisor, Open-Source Value Project, Innovation and Value Initiative, discusses challenges with incorporating more novel concepts of value into value assessment.

When seniors with cancer are being treated with combination therapies, providers need to keep in mind more than just the complex regimens they’re administering, said Ginah Nightingale, PharmD, associate professor of pharmacy practice at Jefferson College of Pharmacy.

Research has shown disparities in multiple myeloma treatment between clinical trials and real-world outcomes, as well as a lot of heterogeneity among treatment patterns by age and region, said Ajai Chari, MD, associate professor of medicine, Hematology and Medical Oncology, Mount Sinai Hospital.

Albert Rizzo, MD, FACP, chief medical officer for the American Lung Association, discusses the use of forced expiratory volume in 1 second (FEV1) /forced vital capacity (FVC) for the diagnosis of chronic obstructive pulmonary disease.

The Consortium of Multiple Sclerosis (MS) Centers is unique in that it places physicians and other healthcare professionals on a level playing field while elevating the patient’s voice to be the most important on the team, explained June Halper, MSN, APN-C, MSCN, FAAN, chief executive officer, Consortium of Multiple Sclerosis Centers.

Traditionally, migraine is thought of as an issue of lost productivity, but there is evidence that there are direct costs on the medical claims side, said Neil Goldfarb, president and chief executive officer of the Greater Philadelphia Business Group on Health.

Lani M. Alison, BSN, MS, HCQ, PCMH, CCE, vice president of Clinical Affairs, Regional Cancer Care Associates, discusses how providers discuss the Oncology Care Model (OCM) with patients and the questions they ask about it.

While there may be negative connotations attached to the term “palliative care,” this type of care could be called “supportive team care” to better express its potential to educate and care for patients with chronic illnesses such as multiple sclerosis (MS), said June Halper, MSN, APN-C, MSCN, FAAN, chief executive officer, Consortium of Multiple Sclerosis Centers.

With the increasing prevalence of more expensive, potentially curative therapies, there comes the question of can we still afford expensive interventions that are that valuable, explained Jeroen Jansen, PhD, lead scientific advisor, Open-Source Value Project, Innovation and Value Initiative.

John Fox, MD, MHA, vice president of Clinical Transformation at Spectrum Health, reacts to the National Comprehensive Cancer Network's call to expand comprehensive genomic testing across several cancers.

Iuliana Shapira, MD, chief medical officer, Regional Cancer Care Associates (RCCA), discusses how data analytics have improved RCCA’s revenue cycle.

Shared decision making has been taught to clinicians for years, but it is especially crucial when treating multiple sclerosis (MS) due to the importance of treatment adherence, according to June Halper, MSN, APN-C, MSCN, FAAN, chief executive officer, Consortium of Multiple Sclerosis Centers.

R. Brett McQueen, PhD, assistant professor, Department of Clinical Pharmacy, Pharmaceutical Outcomes Research, Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of Colorado, explains how multiple-criteria decision analysis be used to aid in coverage and reimbursement decisions for high-cost, innovative therapies.

Division among employers prolongs their inability to alter the healthcare system, but by acting together, value-based care will begin to spark change, said Lauren Vela, MBA, senior director, Member Value, Pacific Business Group on Health.

Innovation is being used to improve quality metrics in oncology care at the patient forefront and in data, explained Lani M. Alison, BSN, MS, HCQ, PCMH, CCE, vice president of Clinical Affairs, Regional Cancer Care Associates.

Accountable care organizations who have been involved in value-based payment for a while are committed to the new model, explained Rob Mechanic, MBA, senior fellow at the Heller School of Social Policy and Management at Brandeis University and executive director of the Institute for Accountable Care.

As new treatments and technologies evolve, it is very important that radiation oncologists have a new alternative payment model for reimbursement, said Shalom Kalnicki, MD, FASTRO, FACRO, professor and chairman, radiation oncology, Montefiore Einstein Center for Cancer Care and Albert Einstein College of Medicine.

Pairing low doses of chemotherapy with newer, targeted drugs can help prevent high toxicity, said Catherine Diefenbach, MD, director of clinical lymphoma at the NYU Langone Perlmutter Cancer Center.

Encouraging patient adherence to medication is very important to managing the cost of multiple sclerosis (MS) therapies, said Patty Taddei-Allen, PharmD, MBA, BCACP, BCGP, director, outcomes research, WelldyneRx.

Jeroen Jansen, PhD, lead scientific advisor, Open-Source Value Project, Innovation and Value Initiative, discusses challenges with today’s approaches to value assessment.

Whether or not there is economic value of comprehensive genomic profiling likely depends on what tissue type and what tumor type we’re talking about, explained John Fox, MD, MHA, vice president of Clinical Transformation at Spectrum Health.