The Future of Healthcare in the United States

Joseph Alvarnas, MD: Well, this has been a great discussion. Before we end, I’d like to ask the panelists for any additional insights regarding their expectation of value-based care in the oncology healthcare setting. Dr Carlson?

Robert Carlson, MD: I always struggle when we talk about value-based care, because value means so many different things to so many different people. Even for individuals, it depends on the context and what we’re talking about in terms of what value really means. My definition of value, when it comes to oncology care, is really whatever the patient tells me it is and that’s what we should focus on. For some patients, that may be finances. For some patients, that may be survival. For some, it may be whether or not they retain the ability to speak after their laryngeal cancer is treated. It can mean many, many different things. So, let the patient tell me what value means, and I’ll accept that definition and work to achieve value for them.

Joseph Alvarnas, MD: Miss Carpenter?

Elizabeth Carpenter: Something that you talked about earlier today was value frameworks and how they are entering into the system. And at Avalere Health, we’ve been partnering with FasterCures, because we’ve looked at value frameworks and not felt like the patient voice has really been represented. So, we are working on a patient-perspective value framework that’s going to take into account feedback from hundreds of patients and stakeholders from across the healthcare system. I would stay tuned for that.

Joseph Alvarnas, MD: Beautiful. And Dr Fox?

John Fox, MD: There’s a new paradigm that the CMMI and the Oncology Care Model are promulgating, and that is physicians being at risk for the total cost of care for cancer patients. I think that for too long, physicians have been insulated from the cost of healthcare, and now they’re actively having discussions about that driven by these value frameworks—including the ASCO Value Framework and the NCCN Evidence Blocks. I think that’s a good thing because it will help get onto the table not only the financial issues that patients face, but also the benefits and risks of the therapies they receive. That’s where the real value is. I agree with Bob that a clear discussion of all the available treatment options and what they cost and what the side effects are is really where we need to go. And I think the patients will drive that, but they need the physicians’ help; they can’t do that in a vacuum.

Joseph Alvarnas, MD: Wonderful. Thank you all. On behalf of our panel, we’d like to thank you for following the Spring 2017 Oncology Stakeholder Summit Series. We hope you found this Peer Exchange^® informative, and we hope you will join us as the series continues. Thank you.