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.

In this video, Robert Bo Gamble, Director, Strategic Practice Initiatives, Community Oncology Alliance, Washington, DC, says that it is critical for payers and providers to come together in oncology management.

New revenue models in healthcare are causing innovative payer-provider partnerships. John Harris, MBA, spoke about some of these new partnerships and how all stakeholders must consider each other's mindsets when choosing a model that works for them.

Michael E. Chernew, PhD; Lee N. Newcomer, MD, MHA; and Sandra M. Swain, MD; examine the treatment benefits, cost concerns, and insurance coverage strategies for pertuzumab.

Earlier this week, Kaiser Health News released an analysis of Medicare data which showed that approximately 2200 hospitals will face penalties this October for having too many patients readmitted for care within 30 days of discharge.

Mark Zitter, MBA, CEO of the Zitter Group, states that oncology pathways can standardize the way care is delivered while improving quality and reducing costs.

Barry Kinzbrunner, MD, Executive Vice President, Chief Medical Officer, VITAS Corporation, states that hospice and palliative care programs are important in the coordination of care for patients.

Much of the focus at AHIP Institute 2012 has naturally been on the issues that affect health plans and payers. However, one session in particular focused on some of the barriers and issues that providers face in today's complex healthcare environment.

To improve formulary design processes and support payers in providing more effective healthcare, policy makers should consider involving commercial payers in the development of comparative effectiveness research and creation of research and treatment guidelines.

Comparative effectiveness research and pragmatic clinical trials are valued methods to address the limitations of traditional randomized trials, answer questions of cost-effectiveness or noninferiority, and inform data-driven dialogue and decision making by stakeholders.