Frederick Schnell, MD, FACP, medical director of COA, discusses how employers' concerns with cancer care coverage can be addressed without compromising quality.
Employers have a huge stake in their employees' health, and therefore should take interest in the sort of health care their employees are provided under their insurance coverage. Frederick Schnell, MD, FACP, medical director of the Community Oncology Alliance (COA), discusses how employers' concerns, particularly with cancer care coverage, can be addressed without compromising care quality.
Transcript
Based on your experience and feedback from member practices, what seem to be the biggest concerns employers have surrounding coverage for cancer care?
The biggest concerns remain focused around cost and quality. But cost is still high. And the major cost issue for most of the employers that we interact with, as it relates to cancer care, is specialty drugs. You really can't make any headway in cancer care delivery in a more cost-effective way without ultimately addressing the drug costs.
[COA] has been focusing a lot of our educational initiatives and interacting with employers on the use of precision medicine tools and have a strong, enduring focus and commitment to making biosimilars work in the marketplace. We have task forces touching on all of these initiatives, as well as those related to clinical pathways and to integrating high-quality clinical care delivered on the ground to these other cost initiatives.
We want the experience to improve, and we believe that quality of care and oncology in COA practices is on equal scale to any. I believe, as a community oncology practitioner for over 30 years, that's very much the case. We're going to try to deliver the value message as we go forward and are trying to develop means of controlling costs as part of quality.
Rethinking the Role of PBMs in Health Care Reform
September 11th 2024Policy changes, such as banning spread pricing and promoting transparency, are necessary to realign the pharmacy benefit manager (PBM) market and ensure that health care resources benefit patients and providers rather than being diverted by middlemen, according to panelists at the Community Oncology Alliance Payer Exchange Summit.
Read More
How Can Employers Leverage the DPP to Improve Diabetes Rates?
February 15th 2022On this episode of Managed Care Cast, Jill Hutt, vice president of member services at the Greater Philadelphia Business Coalition on Health, explains the Coalition’s efforts to reduce diabetes rates through the Diabetes Prevention Program (DPP).
Listen
Finding Common Ground: Addressing PBM Issues and ERISA Tensions
September 10th 2024A panel discussion at the Community Oncology Alliance (COA) Payer Exchange Summit highlighted the tension between state regulation of pharmacy benefit managers (PBMs) and the Employee Retirement Income Security Act (ERISA) preemption, emphasizing the need for reforms to balance employer uniformity with addressing PBM practices.
Read More
Key Issues Influencing 2022 Employer Health Care Strategy and Plan Design
August 31st 2021On this episode of Managed Care Cast, we speak with Ellen Kelsay, president and CEO of the Business Group on Health, on the findings from her organization's 2022 Large Employers’ Health Care Strategy and Plan Design Survey.
Listen
Stakeholder Engagement With State, Local Officials Is Key to Driving Policy Change
September 10th 2024Panelists at the Community Oncology Alliance Payer Exchange Summit 2024 agreed that overcoming health care challenges will depend heavily on collaboration and active engagement from multiple stakeholders in the policy and regulatory process.
Read More
Prescription Rebate Guarantees: Employer Insights
July 19th 2024This study examined employers’ understanding of rebate guarantees, dependency upon rebate dollars, and the role that pharmaceutical rebates or employer benefits consultants play in their pharmacy benefits manager selection.
Read More