Payers

A review of studies going back as far as 1981 shows that using genetic tests to diagnose and treat breast cancer helps save money, but with most research based on modeling, it's time for more support to gather data from real-world settings.

In this interview, Curtis Triplitt, PharmD, associate professor and assistant dean of research, Texas Tech University Health Sciences Center, Permian Basin, explains why diabetes should be treated with a patient-centered approach.

With the unveiling of the first FDA-approved system with the name "artificial pancreas," Medtronic will seek a new CMS code that would cover both the insulin pump and the continuous glucose monitoring parts of the process, according to the company.

In the final segment of the panel discussion, each panel member gave their final thoughts on the discussion topic.

After introducing panelists, Otis Brawley, MD, chief medical officer, American Cancer Society, David H. Finley, MD, FACS, national medical officer, Enterprise Affordability and Policy, Cigna Healthcare, Joy Larsen-Haidle, MS, genetic counselor, Hubert H. Humphrey Cancer Center, Ellen T. Matloff, MS, research scientist, Department of Genetics, director, Cancer Genetic Counseling, Yale Cancer Center and Rebecca Nagy, president, National Society of Genetic Counselors, moderator, Jan Berger MD, MJ, president & CEO, Health Intelligence Partners, editor-in-chief, The American Journal of Pharmacy Benefits, asked the panel to identify the current unmet needs and challenges in genetic testing.

In order to deliver quality and cost-effective cancer care, Michael Kolodziej, MD, Aetna's national medical director for oncology strategies, says that providers need to get better connected with payers.

Panelists agreed that the cost of the new agents discussed to treat melanoma will be a challenge, just as the cost of healthcare as a whole in the United States is a major challenge.

Dr Fendrick asked panelists what they think about the idea of centers of excellence for specific cancers and an evidence-based steerage.

It's very, very complex to try to envision how you would come up with a single payment for an episode and not have a thousand different types of episodes in order to capture the heterogeneity of these diseases and the cost, said Dr Malin when asked to discuss the bundled payment method in oncology.

In this portion of the panel discussion, Dr Fendrick asked the panel whether or not they have noticed cost-related lack of access or nonadherence with the new agents being discussed.

Dr Weber said that despite all of the newer agents in development, the NCCN still offers comprehensive guidelines for the treatment of melanoma.

The American Journal of Managed Care and Precision Health Economics will hold a one-day meeting to promote better partnerships among all partners involved in diabetes management physicians, health plan leaders, policymakers, and the creators of life-saving medicines.

In this video, Karen Ignagni, President and Chief Executive Officer, America's Health Insurance Plans (AHIP), addresses the importance of joining The American Journal of Managed Care's Strategic Alliance Partner Program.

Jeff Goldsmith, PhD, President, Health Futures, Inc, Associate Professor of Public Health Sciences, University of Virginia, says that the biggest barrier that accountable care organizations (ACOs) face is the lack of collaboration between physician communities and hospitals.

In "What Does the Affordable Care Act Actually Do?," presented by Ivor Douglas, MD, Associate Professor, University of Colorado Denver, Chief, Pulmonary Sciences and Critical Care Medicine Director, Medical Intensive Care, Denver Health Medical Center, at the ATS 2013 International Conference, Dr Douglas noted that fundamental issues driving the Affordable Care Act (ACA) include access, quality, and cost.

Scott Halpern, MD, PhD, discussed the Choosing Wisely campaign with his opening presentation on The History of and Rationale for the Choosing Wisely Campaign. As most healthcare providers know, healthcare spending per capita in the United States is significantly higher than most other countries.

Market Dynamics Change How Plans Manage Oral and Office-Administered Agents

The realities of the emerging healthcare marketplace are quickly being recognized. Layna Cook, with law firm, Baker, Donelson, Bearman, Caldwell & Berkowitz, PC, discussed these realities with her presentation, The Impact of Health Reform's State Exchanges.

This article outlines strategies insurers can use to mitigate their risks related to prescription opioid abuse by members, while addressing this serious public health problem.

Health plans are fundamentally transforming the delivery of healthcare for patients by reforming payment models, coordinating care, and partnering with providers.

Dr. Mark Fendrick, MD, Professor of Medicine and Health Management and Policy, Schools of Medicine and Public Health, University of Michigan, Co-Editor-in-Chief, The American Journal of Managed Care, says that there are levers organizations and stakeholders can pull to achieve the goal of improving quality and value in cancer care.

"Oncology is a very emotional area," says Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners, Editor-in-Chief, The American Journal of Pharmacy Benefits.