- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Value of Quality-of-Life Metrics
Traditionally, overall survival and progression-free survival have been the metrics used when evaluating treatment options in oncology. However, Genevieve Kumapley, PharmD, BCOP, suggests that quality-of-life metrics can also be extremely valuable and should be considered, especially when caring for patients with end-stage disease.
Quality-of-life metrics, psychosocial issues, and cultural and social factors need to be considered during end-of-life care, says Dr Kumapley. She explains that treatment options need to be individualized and decided upon based on appropriateness for the patient, especially in patients with end-stage disease.
Considering a treatment option’s toxicity is critical, she adds, because adverse events can have a significant impact on a patient’s quality of life.
Because of the complexity of treatment selection and patient management in oncology, Dr Kumapley explains, it is challenging for payers to incorporate quality-of-life measures into coverage and reimbursement decisions. Although it would be easier for payers to simplify the process by covering only a limited number of drugs, patients with cancers for which there are few treatment options, such as pancreatic, can benefit from new options that have been approved based on quality-of-life metrics, she says.
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
Listen
ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
Read More
Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
Listen
Contributor: For Complex Cases, Continuity in Acute Care Is Necessary
April 23rd 2025For patients with complex needs and social challenges like unstable housing, the hospital has become their de facto medical home—yet each visit is a fragmented restart, without continuity, context, or a clear path forward.
Read More
