Outcomes for patients with cancer are continuously improving, but the increasingly complex healthcare system, new payment and delivery models that place more risk on practices, and rising costs of therapies has made it difficult for independent oncology practices to thrive and survive. However, independent practices present an important part of cancer care, delivering care to patients who are not near large hospital-based systems at lower costs.

Sibel Blau, MD, explains how Quality Cancer Care Alliance is bringing together independent practices and helping them succeed by providing them with best business models, practice efficiencies, and financial advantages.

Read more about the stories in this podcast:

Data and Collaboration Are Key for Value-Based Care Success: https://www.ajmc.com/journals/evidence-based-oncology/2018/december-2018/data-and-collaboration-are-key-for-valuebased-care-success

Strategies for Fighting Consolidation in Community Oncology: https://www.ajmc.com/conferences/coa-2019/strategies-for-fighting-consolidation-in-community-oncology

Dr Ray Page Details Using Triage Pathways and Scaling Them Across Multiple Practices: https://www.ajmc.com/interviews/dr-ray-page-details-using-triage-pathways-and-scaling-them-across-multiple-practices

Barry Russo on How Community Oncology Practices Can Work Together and Learn From Each Other: https://www.ajmc.com/interviews/barry-russo-on-how-community-oncology-practices-can-work-together-and-learn-from-each-other

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included HHS announcing a finalized rule requiring the disclosure of drug prices in television ads; a report finding high satisfaction with employer health coverage despite the cost; a study finding heart failure is surging among young adults.

Read the articles in this podcast:

HHS Finalizes Rule Requiring Disclosure of Drug Prices in TV Ads: https://www.ajmc.com/newsroom/hhs-finalizes-rule-requiring-disclosure-of-drug-prices-in-tv-ads

High Satisfaction With Employer Coverage, but Financial Challenges Persist: https://www.ajmc.com/focus-of-the-week/high-satisfaction-with-employer-coverage-but-financial-challenges-persist

Amgen, Syapse Join Forces for Precision Medicine in Oncology: https://www.ajmc.com/newsroom/amgen-syapse-join-forces-for-precision-medicine-in-oncology

What We're Reading: Medicaid Fraud Settlement; Heart Failure in Young Adults; FDA Investigates Sunscreen: https://www.ajmc.com/newsroom/what-were-reading-medicaid-fraud-settlement-heart-failure-in-young-adults-fda-investigates-sunscreen

Managing Costs in Diabetes Means Intervening Early to Avoid Complications Later, Experts Say: https://www.ajmc.com/focus-of-the-week/managing-costs-in-diabetes-means-intervening-early-to-avoid-complications-later-experts-say

Dr Rebekah Gee Offers an Inside Look at Louisiana's Subscription Payment Model for HCV Drugs: https://www.ajmc.com/managed-care-cast/dr-rebekah-gee-offers-an-inside-look-at-louisianas-subscription-payment-model-for-hcv-drugs

The Louisiana Department of Health and Corrections announced in March 2019 their selection of Asegua Therapeutics, a subsidiary arm of Gilead Sciences, as their pharmaceutical partner for the state’s subscription model for hepatitis C virus treatment.

The alternative payment model, the first of its kind in the United States, was first announced in August 2018 by the Louisiana Department of Health, who explained that HCV infections are a public health crisis within the state. Though highly effective antiviral treatment exists that can largely cure patients with HCV, the price of the treatments remains high, and Medicaid patients and the Department of Corrections population are unable to access the therapies.

Under this model, instead of paying for each prescription individually, the state would pay a subscription fee to the drug company whereby the state would then receive unlimited access to the drug, similar to how consumers pay a monthly fee to stream unlimited television shows and movies.

Today, we’re speaking with Dr Rebekah Gee, secretary of the Louisiana Department of Health and one of the key leaders in bringing this alternative payment model to fruition.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included CMS Administrator Seema Verma calling for more disruption to the healthcare system; former FDA Commissioner Scott Gottlieb, MD, reflecting on the agency’s record of innovation; liraglutide demonstrating promise for youth with type 2 diabetes.

Read more about the stories in this podcast:

CMS' Verma: Upend the Status Quo to Move to Value-Based Care: https://www.ajmc.com/conferences/naacos-spring-2019/cms-verma-upend-the-status-quo-to-move-to-valuebased-care

National Association of ACOs Spring 2019: https://www.ajmc.com/conferences/naacos-spring-2019

In First Speech Since Stepping Down as FDA Commissioner, Gottlieb Reflects on Agency's Push for Innovation: https://www.ajmc.com/conferences/whcc-2019/in-first-speech-since-stepping-down-as-fda-commissioner-gottlieb-reflects-on-agencys-push-for-innovation

World Health Care Congress 2019: https://www.ajmc.com/conferences/whcc-2019

Liraglutide Lowers A1C in Youth With Type 2 Diabetes, Phase 3 Study Finds: https://www.ajmc.com/focus-of-the-week/liraglutide-lowers-a1c-in-youth-with-type-2-diabetes-phase-3-study-finds/

Study: Oncotype DX-Guided Treatment May Cut Breast Cancer Care Costs by $50 Million in US: https://www.ajmc.com/newsroom/study-oncotype-dxguided-treatment-may-cut-breast-cancer-care-costs-by-50-million-in-us

Why Patients Seek Out Medical Cannabis: https://www.ajmc.com/managed-care-cast/why-patients-seek-out-medical-cannabis

Heard at COA: Improving Cancer Care in Community Practices With OneOncology by Managed Care Cast

Earlier this year a paper published in Health Affairs discussed the reasons why patients seek out medical cannabis. We spoke with one of the authors, Kevin F. Boehnke, PhD, a researcher in anesthesiology, about the findings that chronic pain accounted for the majority of all patient-reported qualifying conditions under which US patients sought medical marijuana.

We also discuss other topics related to medical cannabis in the United States, as well as the kinds of future research that would be helpful to understanding this issue.

Today we’re speaking with Dr. Steven Goldberg, the vice president of medical affairs, population health, and chief health officer at Quest Diagnostics. He is also a co-author of a recent peer-reviewed case study that analyzed a benefits and wellness program designed by a self-insured employer. The employer, Quest Diagnostics, covers nearly 60,000 lives. The analysis of the program showed that it was able to reduce costs while maintaining program quality and promoting population health. According to the study findings, through proactive changes, physician executive leadership, health plan collaboration, disease-specific population health initiatives, and plan design, Quest Diagnostic's annual healthcare cost trend steadily improved from a year-over-year trend of 5.7% from 2014 to 2015, to 4.6% from 2015 to 2016, to -1.0% for 2016 to 2017, and most recently, 0.3% in the 2017 to 2018 year.

Every week, The American Journal of Managed Care® (AJMC®) recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included a study demonstrating that diabetes drug canagliflozin cuts the risk of renal failure and death; the FDA approving the first targeted therapy for metastatic bladder cancer; approximately half of all cancer deaths are attributable to modifiable risk factors.

Read more about the stories in this podcast:

CREDENCE: Canagliflozin Cuts Risk of Renal Failure, Death 30% in Patients With Type 2 Diabetes, CKD: https://www.ajmc.com/newsroom/credence-canagliflozin-cuts-risk-of-renal-failure-death-30-in-patients-with-type-2-diabetes-ckd

FDA Approves Erdafitinib, First Targeted Therapy for Metastatic Bladder Cancer: https://www.ajmc.com/newsroom/fda-approves-erdafitinib-first-targeted-therapy-for-metastatic-bladder-cancer

Nearly Half of Cancer Deaths Attributable to Modifiable Risk Factors: https://www.ajmc.com/newsroom/nearly-half-of-cancer-deaths-attributable-to-modifiable-risk-factors

Panelists Offer an Insider Perspective of the Unstable Future of Genetic Testing Reimbursement: https://www.ajmc.com/conferences/flasco-2019/panelists-offer-an-insider-perspective-of-the-unstable-future-of-genetic-testing-reimbursement

FLASCO Spring Session 2019: https://www.ajmc.com/conferences/flasco-2019

Deaths Among Opioid Users: Impact of Potential Inappropriate Prescribing Practices: https://www.ajmc.com/journals/issue/2019/2019-vol25-n4/deaths-among-opioid-users-impact-of-potential-inappropriate-prescribing-practices

The American Journal of Managed Care—April 2019: https://www.ajmc.com/journals/issue/2019/2019-vol25-n4

Understanding the Impact of Inappropriate Opioid Prescribing Practices by Managed Care Cast

As the prevalence of burnout among healthcare providers has increased over the last few years, it has raised attention to the issue. Burnout includes overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and a lack of accomplishment. Among physicians, common drivers include excessive workloads, clerical burdens, organizational structures, and leadership culture.

Greater attention to the issue, and the impact it can have on patient outcomes, has led to more organizations to implement interventions to address and alleviate burnout in healthcare. Bernadette Melnyk, PhD, RN, APRN-CNP, FAANP, FNAP, FAAN, vice president for health promotion, chief wellness officer and professor and dean of the college of nursing at The Ohio State University, highlighted the need for a chief wellness officer, same as healthcare has chief technology and quality officers, and some interventions being implemented.

Learn more about burnout:

Making The Case For The Chief Wellness Officer In America’s Health Systems: A Call To Action: https://www.healthaffairs.org/do/10.1377/hblog20181025.308059/full/

Physicians Are Pessimistic About Future of Healthcare, Highlight Extent of Social Determinants: https://www.ajmc.com/focus-of-the-week/physicians-are-pessimistic-about-future-of-healthcare-highlight-extent-of-social-determinants

Physician Burnout Associated With Poorer Patient Outcomes: https://www.ajmc.com/focus-of-the-week/physician-burnout-associated-with-poorer-patient-outcomes

Dr W. Clay Jackson Discusses Identifying, Addressing Clinician Burnout: https://www.ajmc.com/conferences/psychcongress2018/dr-w-clay-jackson-discusses-identifying-addressing-clinician-burnout

Will HHS' Strategy to Address Health IT–Related Physician Burden Provide Relief for Providers? https://www.ajmc.com/focus-of-the-week/will-hhs-strategy-to-address-health-itndashrelated-physician-burden-provide-relief-for-providers

After Increasing for Several Years, Physician Burnout Shows Modest Decline: https://www.ajmc.com/newsroom/after-increasing-for-several-years-physician-burnout-shows-modest-decline