Interviews

Elizabeth Griffiths, MD, associate professor of oncology, department of medicine, Roswell Park Comprehensive Cancer Center discusses recent approvals for acute myeloid leukemia (AML).

While all treatment regimens for Hodgkin lymphoma can cause neutropenia, the degree and the chance of neutropenic fever varies, explained Alison J. Moskowitz, MD, medical oncologist, clinical director, lymphoma inpatient unit, Memorial Sloan Kettering Cancer Center.

Results from the first 2 performance periods of the Oncology Care Model (OCM) highlighted areas where Northwest Medical Specialties was doing well and areas it could improve, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

With the low cost and high quality of community oncology practices and 40% of Americans living in rural areas, the country needs to preserve and allow community practices to thrive, said Barbara L. McAneny, MD, president of the American Medical Association and CEO of the New Mexico Cancer Center.

The Oncology Care Model (OCM) has been challenging for Texas Oncology as it has for all practices, said Lalan Wilfong, MD, executive vice president of Quality Programs at Texas Oncology.

Patients who are over 60 with Hodgkin lymphoma have much lower survival rates than patients who are under 60, explained Alison J. Moskowitz, MD, medical oncologist, clinical director, lymphoma inpatient unit, Memorial Sloan Kettering Cancer Center.

Opioids can be effective in the right population, but there needs to be greater awareness among providers and health plans on which patients are not appropriate to start on opioids, said Elizabeth Stringer, PhD, chief science and clinical officer of axialHealthcare.

As new, innovative therapies with high price tags, such as chimeric antigen receptor (CAR) T-cell therapy, come to market, the US health system will have to start looking at different approaches for reimbursement, said Ted Okon, MBA, executive director of the Community Oncology Alliance.

There can be great disparities across the country and across races when it comes to cancer care, but clinical pathways can help standardize care so everyone gets the most efficacious treatments, said Robert Daly, MD, MBA, medical oncologist, Memorial Sloan Kettering Cancer Center.

There are additional areas of improvement for Medicare accountable care organizations (ACOs) beyond what was proposed in the Pathways to Success regulation, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs (NAACOS).

Jeff White, PharmD, MS, staff vice president, Anthem, discusses what role Anthem has in addressing the opioid epidemic, as well as how important collaboration with other stakeholders is for addressing the epidemic.

There have been incredible responses to treatments for chronic lymphocytic leukemia (CLL), but there remains a tremendous unmet need for patients, said Brian Koffman, MDCM, DCFP, DABFM, MS Ed, medical director, CLL Society.

Keeping people with cancer out of the hospital is a low-hanging fruit that is of huge benefit to patients, explained Barbara L. McAneny, MD, president of the American Medical Association.

Elizabeth Griffiths, MD, associate professor of oncology, department of medicine, Roswell Park Comprehensive Cancer Center, discusses the prevalence of neutropenia in patients with acute myeloid leukemia and patient/clinical characteristics that can predict which patients will become neutropenic.

The Oncology Care Model (OCM) is not a sustainable model, but while it finishes out the 5-year pilot, CMS will likely be fine-tuning bundled payments in medical oncology, said Michael Kolodziej, MD, vice president and chief innovation officer at ADVI Health, Inc.

While opioids tend to cost very little, they lead to overutilization downstream, so patients with opioid use disorder should be treated in a comprehensive manner that includes behavioral health and social support, said Elizabeth Stringer, PhD, chief science and clinical officer of axialHealthcare.

Implementing the Oncology Care Model required educating physicians and staff on a new way to do the work and why the changes were necessary under the new model, explained Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

As new breakthrough therapies are approved, clinical pathways have to be kept updated in order for patients to get the best treatments, said Robert Daly, MD, MBA, medical oncologist, Memorial Sloan Kettering Cancer Center.

Patients with neutropenia or at risk of it need to be cautious of their diet, said Beth Wittmer, RN, OCN, manager of care management at Florida Cancer Specialists and Research Institute.

The greatest unknown if which reimbursement model for these high-cost therapies will gain supremacy, explained Jane F. Barlow, MD, MPH, MBA, senior advisor, Center for Biomedical Innovation at Massachusetts Institute of Technology.

While patient-reported outcomes don’t provide the whole story, they can provide insight into how chimeric antigen receptor (CAR) T-cell therapy changes a patient’s life, said Brian Koffman, MDCM, DCFP, DABFM, MS Ed, medical director, CLL Society.

Project ECHO can be used to improve access to care in rural and underserved areas by sharing knowledge, said Sanjeev Arora, MD, FACG, MACP, director and founder of Project ECHO and a professor of medicine at University of New Mexico.

Jeff White, PharmD, MS, staff vice president, Anthem, outlines best practices for preventing opioid misuse.

Dan Mendelson, MPP, founder, Avalere Health, discusses how the shift to value-based care has impacted managed care pharmacy.

The American Medical Association (AMA) has 3 main strategic areas it is focusing on to help create the healthcare system of the future that is deserving of doctors’ work and patients’ respect, said Barbara L. McAneny, MD, president of the AMA.

Improvements in treatments have led to less toxicities and better quality of life for patients with breast cancer, said Lawrence N. Shulman, MD, director of the Center for Global Cancer Medicine at the Abramson Cancer Center, and professor of Medicine at the Hospital of the University of Pennsylvania.

Informing patients about what to look for with neutropenia can help keep them out of the emergency department (ED) so they can be treated in the clinic, instead, said Beth Wittmer, RN, OCN, manager of care management at Florida Cancer Specialists and Research Institute.

Years before the Oncology Care Model (OCM) was implemented, Northwest Medical Specialties started preparing by making changes to the personnel in the practice, explained Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

Pushing accountable care organizations (ACOs) to take on risk faster will likely result in ACOs that aren’t ready just dropping out of the program and could impact participation in value-based care, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

There are a number of nonopioid options, as well as nondrug options, for pain management, explained Jeff White, PharmD, MS, staff vice president, Anthem.