Latest Conference Articles

The Oncology Care Model is a leading innovation in the move from fee-for-service to value-based reimbursement in large part because CMS has made adjustments based on physician feedback, according to an agency official who addressed the Community Oncology Alliance Payer Exchange Summit.

Heading into 2019, the idea that oncology practices would fully embrace financial responsibility for clinical decisions still seemed far-fetched for many. And yet, when it was time to make the call, moving to 2-sided risk proved a “simple” decision, said Travis Brewer of Texas Oncology, who took part in a panel offering an update on the Oncology Care Model (OCM) at the start of the Community Oncology Alliance (COA) Payer Exchange Summit, which opened Monday in Tyson’s Corner, Virginia.

Mary Montgomery, MD, associate physician in the Division of Infectious Diseases at Brigham and Women’s Hospital, and an instructor of medicine at Harvard Medical School, discussed emerging treatment strategies for managing HIV during a session at the National Association of Managed Care Physicians 2019 Fall Managed Care Forum, held October 10-11 in Las Vegas, Nevada.

During a session at the National Association of Managed Care Physicians 2019 Fall Managed Care Forum being held October 10-11 in Las Vegas, Nevada, Kathryn Phillips, PhD, founding director of the University of California, San Francisco Center for Translational and Policy Research on Personalized Medicine (TRANSPERS), discussed the emergence and rise of genetic testing, the challenges of determining value and reimbursement, and what’s ahead for these tests.

As of November 2018, Medicaid is the largest healthcare program in the United States, covering 1 in 5 Americans, and over two-thirds of beneficiaries are enrolled in private managed care plans. Alongside this trend are shifts in care delivery under Medicaid, as well as challenges and solutions being posed by value-based care models, all of which was discussed during a session at the National Association of Managed Care Physicians 2019 Fall Managed Care Forum being held October 10-11 in Las Vegas, Nevada.

During a session on population health management at the National Association of Managed Care Physicians 2019 Fall Managed Care Forum, held October 10-11 in Las Vegas, Nevada, Cary Shames, DO, CHCQM, ABQAURP, vice president and chief medical officer, Sharp Health Plan, discussed using an integrated population health model to drive better quality and satisfaction of care while lowering costs.

Value-based models continue to enter the healthcare system, affecting a variety of fields, including primary care. And while success stories have been shared by payers and CMS touts these models as a way to “save” primary care, that's not the current reality, said Theresa Hush, chief executive officer of Roji Health Intelligence, LLC, during a session on population health management at the National Association of Managed Care Physicians 2019 Fall Managed Care Forum, held October 10-11 in Las Vegas, Nevada.

Medication adherence is critical not only to clinical outcomes, such as preventing readmissions, but also to containing costs, with adverse outcomes as a result of nonadherence often resulting in higher costs for both the patient and the healthcare system. Ensuring adherence can be especially challenging among people with mood and psychotic disorders.

During the second plenary at the National Association of ACOs fall meeting, Meridith Seife, deputy regional inspector general, Office of Evaluation and Inspections in the HHS Office of the Inspector General, presented results from a government report identifying strategies of high-performing accountable care organizations that had improved care quality while cutting costs.

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