Interviews

Thomas Marsland, MD, medical oncologist, discusses his take on the CAR T-cell therapy reimbursement plan put forward by CMS.

Stephen Silberstein, MD, director of the Jefferson Headache Center, discusses patient reactions to being prescribed a CGRP inhibitor.

Joann Sciandra, RN, BSN, CCM, associate vice president of healthcare management, Geisinger Health System, discusses which technologies are having the biggest impact for accountable care organizations (ACOs) in better managing the needs of their patients.

Collaboration between cardiologists and endocrinologists are necessary when caring with patients with diabetes who have had cardiovascular issues in the past, said Jaime A. Davidson, MD, FACP, MACE, professor of medicine, Touchstone Diabetes Center, The University of Texas Southwestern Medical Center.

Is chemotherapy really on its way out? Maybe not, said Bruce Feinberg, DO, vice president and chief medical officer of Cardinal Health Specialty Solutions.

Diabetes educators can help patients with diabetes who face financial challenges make appropriate choices and receive assistance to afford medications, said Kellie Rodriguez, RN, MSN, MBA, CDE, director, Global Diabetes Program, Parkland Health & Hospital System.

HIV care delivery has always had an ethos in it of really being based on a team-based approach, explained Stella A. Safo, MD, assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai.

Genetic testing and understanding family history of cancer is important because more and more targeted therapies are coming out that are designed to work with specific mutations or inherited forms of mutations, said Sue Friedman, DVM, executive director of FORCE: Facing Our Risk of Cancer Empowered.

There is generally a greater willingness to pay among just about everybody for rare disease therapies, explained Paul Melmeyer, director of Federal Policy, National Organization for Rare Disorders.

The Oncology Care Model (OCM) is pushing cancer centers and cancer programs to make the changes they knew were needed to improve care delivery and patient experiences, said David Ortiz, OCM program director at Montefiore Einstein Center for Cancer Care.

Circulating tumor DNA (ctDNA) can now allow clinicians to better understand which patients are at high risk of recurrence and should be offered intensified chemotherapy, said Jeanne Tie, MBChB, FRACP, MD, medical oncologist and associate professor at the Walter+Eliza Hall Institute of Medical Research.

Eric Anderson, MD, PhD, vice chair of neurology, quality at SOC Telemed, discusses the growing field of wearable technology for movement disorders like Parkinson disease.

There has been much speculation about the end of chemotherapy in cancer treatment, but it’s not clear how accurate that is, said Bruce Feinberg, DO, vice president and chief medical officer of Cardinal Health Specialty Solutions.

The person-centered factors that drive outcomes in diabetes requires hospital systems that can actually address those needs, said Kellie Rodriguez, RN, MSN, MBA, CDE, director, Global Diabetes Program, Parkland Health & Hospital System.

Pre-exposure prophylaxis (PrEP) is one of the best interventions we have for preventing and stopping HIV transmission, explained Stella A. Safo, MD, assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai.

Wayne Burton, MD, former global corporate medical director for American Express, discusses what he views as the key takeaways from a migraine peer exchange he recently participated in.

Therapies for rare diseases, such as gene therapy, pose very unique challenges to value assessments in a variety of different ways, explained Paul Melmeyer, director of Federal Policy, National Organization for Rare Disorders.

The long time between when a performance period ends and when the report comes out in the Oncology Care Model (OCM) can make it difficult to measure the impact specific changes are making, said David Ortiz, OCM program director at Montefiore Einstein Center for Cancer Care.

Changes with health plans can be disruptive to patients with diabetes who face changes in supplies and medications that make it difficult to manage their disease, said Jaime A. Davidson, MD, FACP, MACE, professor of medicine, Touchstone Diabetes Center, The University of Texas Southwestern Medical Center.

Things like smoking, poor diet, and lack of exercise can increase a person’s risk of developing cancer, but there are some things that are actually more clinically acute outside of family history that every patient needs to look out for, explained Feyi Olopade Ayodele, MBA, chief executive officer at CancerIQ.

In the last 2 decades, the cost of healthcare has risen, but the expectations of self-management for people with diabetes has stayed the same, which has made it more challenging to live with the disease, said Kellie Rodriguez, RN, MSN, MBA, CDE, director, Global Diabetes Program, Parkland Health & Hospital System.

From the health system perspective, there needs to be improvement in treating HIV as a comprehensive disease that now goes into aging, explained Stella A. Safo, MD, assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai.

Alliances are going to help community oncology participate in things that, as individual practices, they don‘t have the opportunity to do, said Barry Russo, chief executive officer of The Center for Cancer and Blood Disorders.

Shoshana Lipson, a patient advocate and founder of the “CGRP & Migraine Community ” on Facebook explains the patient perspective of CGRP inhibitors.

With CancerIQ, we’re really going to be helping push population health into the oncology arena where we can hopefully predict and preempt this very costly and devastating disease well in advance, says Feyi Olopade Ayodele, MBA, chief executive officer at CancerIQ.

The Oncology Care Model (OCM) has set off a ripple of change in cancer care that extends beyond the patients who are in the model, said David Ortiz, OCM program director at Montefiore Einstein Center for Cancer Care.

Humana has expanded its focus to the social determinants of health because issues like food insecurity and lack of transportation impact outcomes even if patients are getting the best medical care, said Bryan Loy, MD, physician lead, oncology, laboratory, and personalized medicine, Humana.

Pharmacists, social support services, an information technology team, and financial counselors all come together to encompass the care for the patient, says Beth Wittmer, RN, OCN, manager of care management at Florida Cancer Specialists and Research Institute.

The advantage of having mandatory models is it enables you to get participation broadly across the community and it allows you to design the bundle in a way that’s not so intent on encouraging participation. If you have voluntary participation you are somewhat limited as to how you could design the bundle, because if you design it too aggressively no one will participate, explained 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®.

Triage pathways can transform practices and save practices and CMS money by keeping people out of the emergency department and hospital, said Ray Page, DO, PhD, president and director of research at The Center for Cancer and Blood Disorders.