- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Presentation 1: Oncology Practice in the Era of PCMHs and ACOs: Square Pegs or Round Holes?
Dr Peter Bach says professionals are looking at opportunities for new payment models and care redesign, but there are also threats that might surface. Each type of insurance payment model has different levels of risk factors. New payment models, such as the UHC pathways program and CMMI demo, have limited risk.
Dr Peter Bach says professionals are looking at opportunities for new payment models and care redesign, but there are also threats that might surface. Each type of insurance payment model has different levels of risk factors. New payment models, such as the UHC pathways program and CMMI demo, have limited risk.
In regard to the future of payment, Dr Bach suggests that models such as the patient-centered medical home and accountable care organization, which boast shared savings, are likely to be useful. For oncology, the general “thrust” is to find savings outside drug expenditures, including reduced use of testing and avoiding hospitalization costs. “The general trend is to move risk, and it’s to move it where the discretionary decisions are made,” says Dr Bach. “It’s not a question of if, but when.”
Dr Bach also elaborates on why the site of care matters. Programs such as 340B, which offers discount drugs to hospitals that treat large populations of poor patients, impact costs. Finally, Bach suggests how this shift in site of care could benefit oncology patients.
Managed Care Reflections: A Q&A With Hoangmai H. Pham, MD, MPH
April 1st 2025To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).
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Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions
October 24th 2024On this episode of Managed Care Cast, we're talking with the author of a study published in the October 2024 issue of The American Journal of Managed Care® that explored prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.
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FDA Approves Cabozantinib for Advanced Pancreatic Neuroendocrine Tumors
March 26th 2025With strong progression-free survival benefits demonstrated in the CABINET trial and updates to National Comprehensive Cancer Network guidelines, this approval reinforces cabozantinib’s role in improving outcomes for patients facing these challenging cancers.
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