Interviews

The National Center for Complex Health and Social Needs sits at the intersection between healthcare and behavioral health and social services, and it is critically important that the systems work together to be able to serve the populations that we need them to serve, said Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

Currently, minimal residual disease testing is being used for prognostication not for treatment decisions, explained Thomas G. Martin, MD, clinical professor of medicine, Adult Leukemia and Bone Marrow Transplantation Program, associate director, Myeloma Program, University of California, San Francisco (UCSF); co-leader, Hematopoietic Malignancies Program, Helen Diller Family Comprehensive Cancer Center.

Faith-based organizations teach members how to live a healthy lifestyle in ways that integrate with their faith, explained Maritza Gomez, program assistant for community engagement at the Camden Coalition of Healthcare Providers.

There are questions of hiring of staff, of leadership buy-in, of funding that all come into play when you are talking of how to scale a model beyond a single site, said Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

There are individuals who have a lot of needs and struggle to navigate different systems to get their needs met, and there are systems that don’t necessarily cooperate, partner, and collaborate in effective ways in order to address the needs of that cohort, said Victor Murray, director for care management initiatives at the Camden Coalition of Healthcare Providers.

The National Center is a place where experts come together, share their learning, redesign systems of care and develop practices and tools to support those who need it most, said Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers.

All providers, regardless of where they work have a role in the shift to value-based care, but independent physicians need to have a voice in the transition, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

The biggest barrier to molecular profile testing right now is a financial one, explained Elizabeth Griffiths, MD, associate professor of oncology, department of medicine, Roswell Park Comprehensive Cancer Center

Jeff Sharman, MD, medical oncologist, Willamette Valley Cancer Institute and Research Center; medical director, The US Oncology Network, explains how personalized medicine has changed the way physicians think about treatment for patients with chronic lymphocytic leukemia (CLL).

As the first clinically integrated oncology network, the Quality Cancer Care Alliance (QCCA) brings together the best practices and shares knowledge on value-based care, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

There needs to be a more trusting partnership between physicians and CMS and other payers that physicians want to deliver the best care to patients at a lower cost, said Barbara L. McAneny, MD, president of the AMA.

Elizabeth Griffiths, MD, associate professor of oncology, department of medicine, Roswell Park Comprehensive Cancer Center discusses which biomarkers and mutational events help determine if a patient would likely benefit from a traditional therapy or if they are more suitable for a clinical trial or upfront allogeneic transplantation.

The electronic medical record (EMR) can be burdensome but having a good value-based care team collecting data can help, said Sibel Blau, MD, medical oncologist at Northwest Medical Specialties, PLLC.

As a physician, Brian Koffman, MDCM, DCFP, DABFM, MS Ed, medical director, CLL Society, was able to leverage his medical and scientific knowledge during treatment for his chronic lymphocytic leukemia (CLL), and he encourages other patients to educate themselves on their illnesses in order to receive the best care.

With a number of difference payment programs being tested, it’s important to have a sophisticated evaluation of these programs to really understand their impact on quality and cost, said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.

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.