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The Oncology Care Model: Additional Concerns
Bruce Feinberg, DO; Scott Gottlieb, MD; Brian Kiss, MD; and Ted Okon, MBA, continue to discuss the Oncology Care Model established by the CMS and how it is likely to affect physicians and their practices.
Dr Kiss explains why his organization opted not to participate in the Oncology Care Model, but rather to collaborate with healthcare systems independently.
The Oncology Care Model will impact the physician’s choice to see and care for Medicare patients, projects Dr Gottlieb. Additionally, he remarks, the new model is likely to further affect community practices and result in consolidation because of its complex structure and burden on physicians.
Because the model includes a vast number of performance-based measures, and because these measures are constantly changing, physicians don’t understand how they are being measured, explains Mr Okon. To describe the effect of this issue, he compares a physician who attempts to work under the new model with an athlete who tries to play golf blindfolded.
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Facilitators of and Barriers to Medicaid Investment in Electronic Consultation Services
March 5th 2025In this qualitative investigation, leaders of Medicaid managed care plans were interviewed to identify facilitators of and barriers to electronic consultation for specialty care delivery.
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Higher UTI Risk After Spinal Fusion in Patients With Certain Comorbidities
March 5th 2025A study investigated the incidence of postoperative urinary tract infections (UTIs) in patients undergoing spinal fusion for deformities, finding that patients with more than 12 levels fused had the highest UTI rates.
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