Dr Kashyap Patel on Pressing Topics in Cancer Care Delivery to Be Discussed at PCOC 2020

The top 3 issues relevant within cancer care delivery to be discussed at this year's virtual Patient-Centered Oncology Care Conference 2020 will include coronavirus disease 2019 (COVID-19), pharmacy benefit managers, and alternative payment models, said Kashyap Patel, MD, CEO of Carolina Blood and Cancer Care, associate editor of Evidence-Based Oncology™, and vice president of the Community Oncology Alliance.

Transcript

AJMC®: Patient-Centered Oncology Care will feature many speakers on aspects of federal policy, both within and beyond CMS. As a leader of the Community Oncology Alliance, what do you think will be the pressing topics, and what do you hope to gain?

Dr Patel: So, the Patient-Centered Oncology Care Conference typically addresses the current issues that are challenging the delivery of cancer care across all the settings. In the current situation, the biggest topics that concern us is number 1, the access to care amid the COVID-19 global pandemic. That’s first and that’s an immediate term.

The other thing that affects all of us is the issue of the PBM [pharmacy benefit manager]. So, 30% of all the cancer drugs are now available in the order space which is either dispensed by the clinicians or dispensed by the PBMs, and there has been so much opacities in how the [PBMs] come back with the recommendations for the approval, disapproval, the steps that are to be added to all of that, so we can create a significant discrepancy in access to care across the country. So, that’s the second issue.

The third issue is where we are heading with the alternate payment model, particularly when you look into how we are reaching toward the sunset part of the Oncology Care Model, and we were supposed to have some sort of guidelines on the application process for Oncology Care First, but with, again, the global pandemic and the COVID-19 challenges in public health emergencies, everything has been on hold.

So, the big 3 issues that I think are of relevance are of course the alternate payment model, the Oncology Care First; second one is access to care, particularly as long as the oral treatment for the cancer is concerned, step therapy adage; and the third thing is, of course, the global pandemic. I just want to add the biosimilars now. Biosimilars are available across all these therapeutic lines. So, these are the main issues that I think are going to be very relevant in discussion about how we navigate our path to the next phase in this situation.

AJMC®: What questions do you have for our keynote speaker, Alexandra Chong, PhD, of CMMI?

Dr Patel: Alexandra actually is very heavily involved in both the operations and designing of the newer model, and the biggest question I would have with her is how far they have come along in the design of the model. When they initially announced the Oncology Care First model on November 4th or 5th of last year, they came back with some suggestions that included ePRO [electronic patient-reported outcomes], and of course, they’ve taken into consideration lots of feedback points from the stakeholders like us, Community Oncology Alliance, ACCC, AMA president Dr Barbara McAneny, and all of us—and [I want to ask] how many of those concerns have been addressed, when do they plan to announce the new model, and when they're going to actually sunset the current model.

So, these are some of the uncertainties that we’re still navigating through. So, my biggest question to her will be, when will they announce and when would they announce the details of the model as well.

AJMC®: This year’s meeting will feature a panel to discuss progress in chronic care management. What topics will this panel cover, and what ideas that you use in practice would you like to discuss?

Dr Patel: Chronic care management has been one of the most successful programs developed on the foundation of the Robert Wood Johnson–supported study about 10 years back when the entrance in the study, the MediCal beneficiaries with 2 or more chronic conditions that are going to last 12 months and beyond that, and how it could impact the access to care—how we could reduce the likelihood of patients using the emergency room because they didn’t have access to care.

So, chronic care management, how do we implement it? Particularly, the global pandemic has highlighted the role of telehealth, and chronic care management actually was the precursor of a lot of the operational finitude of telehealth. So, I would like the speakers to elaborate upon how to operationalize, how to enroll patients, how do you create a care plan, how frequently do you call, how do you act if you find that somebody needs access to care—all of these are operational details, as well as enrollment details that will be relevant for the audience to hear about chronic care management.