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Technology has made it easier to deliver health care in the home in recent years, but the financing models have not caught up just yet.

The American Society of Hematology has adopted 10 of the recommendations from Choosing Wisely to encourage more high-value care, but barriers to adoption remain.

Administrator Seema Verma said the proposal would create opportunities "for drug manufacturers to have skin in the game through payment arrangements that challenge them to put their money where their mouth is."

Unlike in fee-for-service, we have an amazing opportunity to begin to understand and build in factors that will keep patients healthy and give them the best outcomes possible, said Lili Brillstein, CEO of Brillstein Collaborative Consulting, and former Director for Episodes of Care at Horizon Blue Cross Blue Shield of New Jersey.

There will never be all mandatory payment models or all value-based models, but we can craft a value-based model around just about anything as long as everybody agrees on what the criteria is, said Lili Brillstein, CEO of Brillstein Collaborative Consulting, and former Director for Episodes of Care at Horizon Blue Cross Blue Shield of New Jersey.

When deciding which treatments to cover, states and commercial payers must wrestle with opportunity costs as new therapeutics come to market. A panel at Virtual ISPOR 2020 discussed some of the factors that go into those decisions.

New technologies and quick drug approvals contribute to the challenges of incorporating value-based care in oncology, said Lili Brillstein, CEO of Brillstein Collaborative Consulting, and former Director for Episodes of Care at Horizon Blue Cross Blue Shield of New Jersey.

Two of the panelists appearing during the Virtual ISPOR 2020 meeting preview what's needed in improving value assessment: Lou Garrison, PhD, of the University of Washington, and Leah Howard, JD, of the National Psoriasis Foundation.

We spoke with Dr Mark Fendrick, co-editor-in-chief of The American Journal of Managed Care®, and director of the University of Michigan Center for Value-Based Insurance Design, or V-BID, on how the principles of V-BID can be used to make a real difference for the millions of American families financially struggling with the impacts of coronavirus disease 2019 (COVID-19) and can help shape the new healthcare delivery landscape after the pandemic.

Oncology practices in 2-sided risk arrangements have reported mixed results, pointing to the need for more time to make the transition, said Michael Diaz, MD, president of Community Oncology Alliance.

Individuals should register for Community Oncology Alliance's virtual meeting to hear "amazing" speakers present groundbreaking research, said Lalan Wilfong, MD, medical oncologist and vice president of value-based care and quality programs at Texas Oncology.

The expansion of Medicare Advantage benefits patients, but presents challenges in oncology care, said Jeffrey Lowenkron, MD, chief medical officer of The Villages Health.

Networking with other practices, sharing ideas, and getting physicians involved in the process can aid community practices moving to alternative payment models (APMs), said Michael Diaz, MD, president of Community Oncology Alliance.

“Quest for Value: Advancing Oncology Value-based Care,” this year’s first installment in the Institute for Value-Based Medicine (IVBM) from The American Journal of Managed Care®, zeroed in seniors, a population that’s growing not just in Florida but across the United States. Older Americans are more likely to develop cancer, but thanks to better detection and treatment, they are more likely to survive cancer, too.

Part of the reason COA recommended a 'ramp up' period is we need time for the vendors to understand what they need to be incorporating in their software, said Michael Diaz, MD, president of Community Oncology Alliance.

"I am not convinced yet that the Oncology Care First Model truly takes into account necessary elements, including high-cost drugs," said Lucio Gordan, MD, president and managing physician at Florida Cancer Specialists.

"There is this mentality that hospice means the patient is going to die very soon, and that's really not true," said Maen Hussein, MD, physician director of finance at Florida Cancer Specialists.

Sharing records and encouraging conversation will promote better collaboration between primary care and cancer care, said Jeffrey Lowenkron, MD, chief medical officer of The Villages Health.

"We want to make sure practices have time to learn, understand, adapt, and modify, to a new Oncology Care Model," said Michael Diaz, MD, president of Community Oncology Alliance.

Educating primary care providers and patients on accessible lung cancer screenings can help reduce lung cancer mortality, said Maen Hussein, MD, physician director of finance at Florida Cancer Specialists.

There has been significant improvement in payers' understanding of site of care issues, but steps still need to be taken to address these issues, said Lucio Gordan, MD, president and managing physician at Florida Cancer Specialists.

Coverage from the Institute for Value-Based Medicine® session held in Nashville, Tennessee.

In today’s Managed Care Cast, we bring you portions of the panel discussion during the the last Institute for Value-Based Medicine® (IVBM®) event for 2019, where oncologists and others shared their thoughts, successes, and frustrations with the current Oncology Care Model, as well as the question and answer session.

Richard Snyder, MD, executive vice president of Facilitated Health Networks and chief medical officer at Independence Blue Cross, discusses key features that payers should include when implementing a value-based agreement.

Accountable care organizations (ACOs) have saved Medicare a total of $3.53 billion from 2013 to 2017, or $755 million after shared savings were paid out, according to a new report from the National Association of ACOs (NAACOS).