Payer Management of Oncology: An In-Depth Look

On Friday, November 16, The American Journal of Managed Care hosted its first annual live meeting, Translating Evidence-Based Research into Value-Based Decisions in Oncology. The conference, which brought together stakeholders from all sides of the managed care industry, provided an arena for healthcare professionals to discuss new, innovative payment models being utilized by both payers and providers.

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, spoke about the importance of the meeting in his opening remarks. “It’s a pleasure to have a meeting where we can reach so many decision makers in a rapidly advancing healthcare system. It’s time to shift the focus from how much we spend to how well we spend.”

Michael Chernew, PhD, Professor of Health Care Policy, Harvard Medical School, Vice Chairman, MEDPAC, Co-Editor-in-Chief, The American Journal of Managed Care, added, “What AJMC has done quite well in a meeting like this is bring people from across the spectrum together to discuss these issues. Keynote speaker Cliff Goodman, PhD, is the national expert in evidence-defined value. We have clinical experts, such as Dr. Peter Bach, who are world renowned in their knowledge of the issues surrounding oncology. And, we have a tremendous group of folks in the audience from both payers and industry to really have a thoughtful discussion about how exactly we are going to navigate the fiscal challenges the industry faces in order to allow individuals who have cancer to have access to the medications that can improve their lives.”

The meeting featured a number of the nation’s premiere thought leaders in oncology. Cliff Goodman, PhD, Senior Vice President, The Lewin Group, spoke about evidence requirements, personalized care, and innovation in cancer care. Bruce A. Feinberg, DO, Vice President and Chief Medical Officer, Cardinal Health Specialty Solutions, presented on the practical application of clinical pathways. Ira M. Klein, MD, MBA, FACP, Chief of Staff, Office of the Chief Medical Officer, National Accounts Clinical Sales & Strategy, Aetna, discussed the importance of quality measures in oncology. And, Peter B. Bach, MD, MAPP, Director, Center for Health Policy and Outcomes, Attending Physician, Memorial Sloan-Kettering Cancer Center, provided an excellent look at the current evolution of accountable care organizations.

Perhaps the highlight of the meeting was the final session on the agenda, which featured the presenters in an interactive question-and-answer roundtable that gave attendees the opportunity to reflect on the day’s presentations. This session provided invaluable access to the nation’s brightest minds and resulted in a thoughtful dialogue on topics, such as healthcare reform, comparative effectiveness research, evidence-based payment models, and the overall evolution of oncology care.

“It was great to see how receptive the audience was to these presentations, and the discussion that was generated was truly an example of how progress can be made when representatives from all sides of managed care are able to come together,” said Brian Haug, President, The American Journal of Managed Care. “We are very thankful for the interest in this conference and look forward to building on our success for next year’s gathering.”