Dr Kibum Kim on Precision Medicine in Managed Care
October 25th 2018There has been dramatic growth in the number of labels relevant to precision medicine, but there remains a gap in the number available and what health plans actually cover, explained Kibum Kim, PhD, MSc, research assistant professor, University of Utah.
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Massachusetts Medicaid Finds CAR T-Cell Payment Solution While Waiting on CMS
October 25th 2018A life-saving therapy is challenging to administer and poses financial risks for patients and institutions alike. Speakers at the Academy of Managed Care Pharmacy Nexus 2018 address some approaches to paying for it while CMS develops long-term policies.
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Dr Jennifer Graff on Using Real-World Evidence to Deliver High-Quality Care
October 24th 2018Real-world evidence helps to inform high-quality care in a number of different ways, and health information technology has really improved the quality and the caliber of real-world data available, explained Jennifer Graff, PharmD, vice president of comparative effectiveness research, National Pharmaceutical Council.
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Dr Christopher Diehl Explains the Pharmacist's Role in Value-Based Models
October 24th 2018Christopher Diehl, PharmD, MBA, BCACP, clinical pharmacist, Excellus BlueCross BlueShield, discusses how the role of pharmacists has evolved with presence of value-based models and how pharmacists can ensure these value-based models succeed.
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Analysis Finds HIV Therapy Biktarvy Associated With Cost Savings Compared With Most Regimens
October 24th 2018The combination therapy lets patients take a single pill once a day for treatment, which leads to improved adherence. Results of the study were presented at the Academy of Managed Care Pharmacy Nexus 2018 in Orlando, Florida.
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Law to Curb Opioid Abuse Will Have Many Managed Care Priorities, Experts Say
October 24th 2018A major bill to curb opioid abuse and the Trump administration's blueprint to rein in drug prices highlighted a busy year in the legislative and regulatory arena for the Academy of Managed Care Pharmacy.
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Dr Jane F. Barlow: How Curative, High-Cost Therapies Bring Challenges to the Reimbursement Landscape
October 24th 2018The introduction of new curative—or durable—treatments has brought 3 challenges to the reimbursement landscape, explained Jane F. Barlow, MD, MPH, MBA, senior advisor, Center for Biomedical Innovation at Massachusetts Institute of Technology.
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Dr Thorvardur Halfdanarson on if He Thinks There's a Future For Immunotherapy in NETs
October 23rd 2018It’s fair to say that the initial results of immunotherapy in neuroendocrine tumors (NETs) have been somewhat disappointing, explained Thorvardur Halfdanarson, MD, associate professor of medicine and consultant in medical oncology, Mayo Clinic.
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Stephen Nuckolls Outlines His Greatest Challenges and Opportunities of the Proposed MSSP Changes
October 23rd 2018The proposed risk adjustment changes to the Medicare Shared Savings Program (MSSP) are welcome but moving accountable care organizations (ACOs) to risk too soon could harm the program, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.
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Dr Rob Fields Discusses Why More ACOs Might Turn to Medicare Advantage
October 21st 2018The push to get accountable care organizations to take on risk faster could lead to more participation in Medicare Advantage, said Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System.
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Dr Scott Paulson on Standard of Treatment, Novel Approaches Being Taken in GEP-NETs
October 19th 2018Scott Paulson, MD, co-director of the Gastrointestinal Research Program for The US Oncology Network, medical director for the Neuroendocrine Research and Treatment Center at Baylor Charles A. Sammons Cancer Center, Baylor University Medical Center, explains the current standard of treatment and novel approaches being taken in gastroenteropancreatic neuroendocrine tumors (GEP-NETs).
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Dr Joe Antos: Proposed MSSP Changes Not a Major Shift in Policy for ACOs
October 18th 2018CMS’ proposed changes to the Medicare Shared Savings Program (MSSP) doesn’t represent a major shift in policy stance toward accountable care organizations (ACOs), said Joe Antos, PhD, the Wilson H. Taylor Resident Scholar in Health Care and Retirement Policy at the American Enterprise Institute.
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Dr Heloisa Soares on the Importance of Multidisciplinary Care, Patient Engagement in NETs
October 17th 2018Heloisa Soares, MD, assistant professor, University of New Mexico Cancer Center-Albuquerque, discusses the importance of treating neuroendocrine tumors with a multidisciplinary team, as well as the importance of engaging patients and their families in their care.
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Allison Brennan: Trump's Administration Is Encouraging Risk, but Possibly Too Quickly
October 16th 2018By encouraging more providers to take on risk faster, the current administration may actually be disincentivizing providers from participating at all, which would reduce the number of accountable care organizations (ACOs), said Allison Brennan, MPP, senior vice president of government affairs for the National Association of ACOs.
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Stephen Nuckolls: 2 Years Isn't Enough Time for an ACO to Take on Risk
October 14th 2018The proposed changes to the Medicare Shared Savings Program that move accountable care organizations (ACOs) to take on risk in just 2 years is not going to be enough time for most ACOs, although some may be ready in that time, said Stephen Nuckolls, CEO of Coastal Carolina Quality Care.
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Predictability and Simplicity Needed to Help ACOs Take on Risk, Panelists Say at NAACOS
October 8th 2018During the opening plenary and panel at the fall 2018 meeting of the National Association of ACOs (NAACOS), Adam Boehler, of the Center for Medicare and Medicaid Innovation, highlighted the fact that CMS has to provide predictability and simplicity to get more accountable care organizations to take on risk and succeed, but that those who are not "cutting it" should "get out of the way" for others.
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Dr Rob Fields Discusses How the Proposed MSSP Changes Impact Decisions Around ACOs
October 8th 2018Rob Fields, MD, assistant profession, family medicine and community health, Icahn School of Medicine at Mount Sinai, and senior vice president, chief medical officer, population health at Mount Sinai Health System, discusses how Mount Sinai’s accountable care organizations (ACOs) will have to adjust to the proposed CMS Medicare Shared Savings Program (MSSP) changes.
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Research at NANETS Cites Value of Genetic Testing in Neuroendocrine Tumors
October 7th 2018Two posters presented at the North American Neuroendocrine Tumor Society (NANETS) annual meeting, October 4-6 in Seattle, Washington, lend support to the idea of targeted treatment for neuroendocrine tumors.
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A Comprehensive Look at Updates, Developments in NETs
October 7th 2018During a session at the North American Neuroendocrine Tumor Society annual meeting, held October 4-6 in Seattle, Washington, Thorvardur Halfdanarson, MD, associate professor of medicine and consultant in medical oncology, Mayo Clinic, outlined the biggest news and updates in the treatment of neuroendocrine tumors (NETs).
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An Update on Lung NET Guidelines
October 7th 2018During a session at the North American Neuroendocrine Tumor Society (NANETS) annual meeting, held October 4-6 in Seattle, Washington, Sukhmani Padda, MD, assistant professor of medicine, Stanford University Medical Center, gave an overview of updates made to lung neuroendocrine tumor guidelines.
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Dr Thorvardur Halfdanarson Outlines New, Exciting Developments in Treatment of NETs
October 7th 2018Thorvardur Halfdanarson, MD, associate professor of medicine and consultant in medical oncology, Mayo Clinic, discusses peptide receptor radionuclide therapy and other new and exciting developments in the treatment of neuroendocrine tumors (NETs).
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Dr Clif Gaus Highlights Excitement and Anxiety at NAACOS Fall 2018 Meeting
October 6th 2018Accountable care organizations (ACOs) are of 2 minds right now. On the one hand, there is a lot of excitement for the future of ACOs, but there is also great anxiety around the changes that CMS proposed for the Medicare Shared Savings Program (MSSP), said Clif Gaus, ScD, president and CEO of the National Association of ACOs (NAACOS).
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