Value-Based Care

Through the integration of a population health reimbursement model in 2020, Allina Health Cancer Institute was able to implement expanded screening initiatives through the use of artificial intelligence and precision medicine, according to Mike Koroscik, MBA, MHA, vice president of oncology, Allina Health.

Melissa Levine, MD, a family medicine specialist at Arizona Community Physicians and medical director for the Abacus Health accountable care organization (ACO), discussed strategies for succeeding in an ACO and how primary care can complement oncology care for patients with cancer.

At the 2023 COA Payer Exchange Summit being held October 23-24 in Reston, Virginia, Lalan Wilfong, MD, US Oncology Network, emphasizes the importance of oncology care equity, ensuring continuity of care, and enhancing care coordination.

This analysis demonstrates value and innovation of direct-acting antivirals for the treatment of chronic hepatitis C in the US Kaiser Permanente health system.

Kristine Slam, MD, FACP, Central Ohio Surgical Associates, addresses the importance of involving patients in decisions regarding their goals for treatment, emphasizing that this involvement is critical to uncover what they value, as well as their short- and long-term goals for treatment.

Alma Habib, MD, The Ohio State University Comprehensive Cancer Center, talks about the fact that disparities are able to be recognized in leukemia/lymphoma care, but the questions of how to address these disparities remain.

Jennifer Vaughn, MD, discusses how value-based care in hematology should consider cost and financial toxicity, as well as valuable patient experience.

Sarah Wall, MD, talks about how it’s important to consider patient age when treating older patients with cancer because it will impact so many of them and blood cancers act differently and can be more aggressive in older adults.

Sarah Boyce, president and CEO at Avidity Biosciences, discusses her leading role at the company, as well as antibody oligonucleotide conjugate drug, AOC 1044, currently in development for Duchenne muscular dystrophy (DMD) with mutations amenable to exon 44 skipping (DMD44).

Rajini Katipamula-Malisetti, MD, executive vice president of Minnesota Oncology, defined value-based cancer care and its importance.

A presentation at the Association of Community Cancer Centers’ 40th National Oncology Conference explored how a cancer screening initiative can be sustainable and revenue positive while driving value-based savings in an evolving market.

Rhonda Henschel, US Oncology Network's vice president of payer relations, summarized what she learned from the Minnesota Oncology IVBM and discussed new developments in the value-based cancer care space.

Jennifer Sturgill, DO, Central Ohio Primary Care, discusses how shortages of antibiotics and medications for attention-deficit/hyperactivity disorder have affected primary care, as well as addresses the impact on heart failure care of CMS’ recent announcement of the first 10 drugs up for price negotiation in 2026 under the Inflation Reduction Act (IRA).

Olalekan Ajayi, PharmD, MBA, 2023-2024 president of the Association of Community Cancer Centers (ACCC) and chief operating officer of Highlands Oncology Group, PA, reflects upon his role at ACCC and highlights key topics in oncology care and cancer research that will be presented at the National Oncology Conference.

Fee-for-service care is not really in line with how primary care physicians think or how primary care should be delivered; the crux of value-based care is wanting patients to have the care they want and need, noted Kristin Oaks, DO, Agilon regional medical director at Central Ohio Primary Care.

This year’s 40th National Oncology Conference from the Association of Community Cancer Centers (ACCC) will take place in Austin, Texas, from October 4-6, with content designed to reflect the theme of “Reimagining Innovation.”

In this interview from our recent Institute for Value-Based Medicine® event, Kristine Slam, MD, FACP, Central Ohio Surgical Associates, discusses the positive impact that Choosing Wisely and enhanced recovery after surgery, or EROS, protocols have had on patients receiving treatment for breast cancer.

Adam Kittai, MD, discusses how value and waste in treatment are imperative to consider in value-based care for blood-based cancers.

Jennifer Sturgill, DO, inpatient medical director of population health, Central Ohio Primary Care, co-presented “Value-Based Care: What Is It and Why Should We Care?” at our most recent Institute for Value-Based Medicine® event with the Zangmeister Cancer Center of Columbus, Ohio, on September 14.

Kristin Oaks, DO, Agilon regional medical director at Central Ohio Primary Care, spoke at our recent Institute for Value-Based Medicine® event held with Zangmeister Cancer Center. Here, she addresses the importance of value-based care within the primary care space.

Most people don’t know they have hypertension, and a new recommendation advises that pregnant women should be screened for blood pressure disorders at every appointment; patients in primary care face long wait times, which may be due to physician incentives under value-based payments; a lawsuit in New Jersey targets the residency requirement to allow aid in dying for those out of state.

We are in the midst of a transformative time in oncology that could also be a little scary if you are not prepared, said Nicolas Ferreyros, managing director of policy, advocacy, and communications, Community Oncology Alliance.

During this session at the National Comprehensive Cancer Network (NCCN) Policy Summit, Yelak Biru, MSc, and Crystal S. Denlinger, MD, explained the importance of screening for and addressing health-related social needs.

In this interview from our Institute for Value-Based Medicine® event, held in partnership with the Zangmeister Cancer Center of Columbus, Ohio, on September 14, Kristine Slam, MD, FACP, Central Ohio Surgical Associates, discusses the benefits of value-based care in the breast cancer space.

Specialty pharmacy is a big area of growth, with opportunity for patients, and specialty pharmacists can help payers and insurers ensure that patients get the full value of oncology medications, noted Andre Harvin, PharmD, MS, MBA, chief pharmacy officer, Oncology Services, Cone Health Cancer Centers.

Jordan Berlin, MD, FASCO, of Vanderbilt University Medical Center, explained how patient preferences and new treatments are considered, as well as what he is currently working on and his biggest takeaway from The American Journal of Managed Care®’s Institute for Value-Based Medicine® held in Nashville, TN on August 17, 2023.

In a large, integrated health system participating in value-based care, higher costs and utilization were observed before and after unplanned dialysis initiation.

The revisions to the ACO REACH model are expected to add predictability and stability while advancing health equity.

Most trust literature investigates missing trust and health care underuse. The authors show that mistrust also leads to health care overuse, a rapidly growing problem in the United States.

The program, which scales an accountable care organization (ACO) model across all major payers in Vermont, reduced Medicare spending and hospitalizations while improving patient care.