Interviews

Richard Umdenstock, president and chief executive officer, American Hospital Association, says that many Americans who are newly insured have not had a high level of interaction with the healthcare system. Some people in this patient population might not even know that there are opportunities to engage with members in their community.

Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners, and editor-in-chief of The American Journal of Pharmacy Benefits, explains that next generation sequencing involves gaining a better understanding and deeper knowledge of the subject, not just another "test here or a test there."

Amy Berman, BS, RN, senior program officer at the John A. Hartford Foundation, says that the triple aim promotes better health, better care, and lower costs. All too often, however, current oncology treatment regimens do not achieve the triple aim.

Len Nichols, PhD, director of the Center for Health Policy Research and Ethics (CHPRE) and a professor of Health Policy at George Mason University, says that transparency in healthcare is an important concept.

Dennis Scanlon, PhD, professor of health policy and administration at Penn State University, says that it is important to consider what details patients need in order to make informed decisions. For payers, this might include informing consumers about enrollment decisions.

Farzad Mostashari, MD, CEO, Aledade Inc, former National Coordinator for Health Information Technology, says that the Blue Button Initiative is a concept that allows patients to receive a copy of their own health information and use it however they like.

Comparative effectiveness research (CER) collaborative tools can benefit pharmaceutical companies in a variety of ways.

It is well known that oncology care pathways are the tools that practices can utilize to care for its patients. Ira Klein, MD, MBA, FACP, chief medical officer, National Accounts Clinical Sales & Strategy, Aetna, suggests that Aetna's only involvement in creating these pathways should be in helping these practices develop "reasonable care pathways."

Michael Bousselot, policy advisor, Office of the Governor for the state of Iowa, believes that the Healthiest State Initiative effectively improves the populations' health and wellbeing because it is privately led and publicly endorsed.

Laurel Pickering, MPH, president & CEO of the Northeast Business Group on Health, explains that employers are transitioning employees into consumers with the help of "transparency tools" centered around price and quality.

While electronic health records (EHRs) enable Geisinger Health System to integrate and partner with new systems, Michael Evans, RPh, director, ambulatory clinical pharmacy programs, Geisinger Health System, suggests that the organization's pre-established managed care process is what sets Geisinger apart in the integrated delivery network/accountable care organization (IDN/ACO) marketplace.

Ed Cohen, PharmD, FAPhA, senior manager, product development, corporate innovations at Walgreens, explains that patient education and medication adherence are 2 major gaps in transitions of care.

Anthony Rothschild, MD, a professor at the Irving S. and Betty Brudnick Endowed Chair of Psychiatry, University of Massachusetts Medical School, says that many primary care physicians feel more comfortable prescribing newer anti-depressant drugs with fewer side effects.

Paul N. Van de Water, senior fellow, Center on Budget and Policy Priorities, suggests that controlling healthcare costs and spending is a complicated process - one in which no right answer exists.

Paige Cooke, assistant director, customer engagement, National Committee for Quality Assurance, says that primary care practices cannot effectively deliver patient-centered care without coordinating a patient's care across different healthcare settings.

Ira Klein, MD, MBA, FACP, chief medical officer, National Accounts Clinical Sales & Strategy, Aetna, suggests that oncology practices lack a sense of economic perspective that would otherwise allow them to offer a variety of services to their patients.

Leonard Fromer, MD, executive medical director, group practice forum and assistant clinical professor, Department of Family Medicine, University of California, says that proactivity and community collaboration are the best tools to aid transitions of care programs in new care delivery models.

Kimberly Westrich, director for health services research for the National Pharmaceutical Council (NPC), says that the NPC determined many accountable care organizations (ACOs) are not yet prepared to maximize the value of pharmaceuticals in patient care.

Michael Evans, RPh, director, ambulatory clinical pharmacy programs, says that medication therapy management (MTM) programs present various challenges. In particular, those challenges include medication reconciliation, ensuring that patients are adherent to their medications, and clinician prescribing practices.

Avik Roy, senior fellow, Manhattan Institute, suggests that in order to improve the quality of care for the poor, one must examine the holes in the Medicaid program. Mr Roy says that first and foremost, Medicaid beneficiaries do not have access to both primary and specialty physicians to the extent that they should in order for them to receive adequate care.

David Alain Wohl, MD, associate professor, division of infectious diseases, University of North Carolina at Chapel Hill, suggests that quality management of HIV has, for the most part, been self-regulated. He says that when it comes to HIV management, there is a lack of feedback or "quality improvement mechanisms" outside the managed care setting.

Toby Cosgrove, MD, president and CEO, the Cleveland Clinic, says that because smoking is such a major contributor to our nation's healthcare woes, the Clinic has encouraged college campuses to go smoke-free. This, he believes, will help reduce the large percentage of smokers who adopt the habit while in school.

David B. Hoyt, MD, FACS, executive director, American College of Surgeons (ACS), says that his organization has studied the concept of improving and sustaining quality while lowering costs. They find there are a variety of results when it comes to hospitals creating, meeting, and maintaining quality standards.

Gregory L. Fricchione, MD, of Harvard Medical School, says that patients suffering from non-communicable disease face a number of challenges.

Rebecca Killion, MA, McKenna Long & Aldridge, says that patients' adherence to diabetes treatment is anything but simple.

Tracy Watts, senior partner at Mercer Human Resource Consulting, says that health management programs are hugely important.

Anthony Slonim, MD, DrPH, CPE, FACPE, executive vice president, chief medical officer, at Barnabas Health says that being a member of The American Journal of Managed Care's ACO and Emerging Healthcare Coalition is valuable.

John Neal, vice president, EMD Serono Managed Markets, says that this year's EMD Serono Specialty Digest identifies several emerging trends in health plans.

Avik Roy, senior fellow, Manhattan Institute, says that the problem with the community rating provision is that age bands can make insurance costly for young patients.

Eleanor Perfetto, PhD, MS, professor, pharmaceutical health services research, School of Pharmacy, University of Maryland, says that incorporating comparative effectiveness research (CER) into pharmacy curriculums is important for the next generation of pharmacists.