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Live Conference Coverage @Medcity Converge 2018 Philadelphia: Oncology Value Based Care and Patient Management

Posted in Healthcare costs and reimbursement, Healthcare Reform, Medicare and Medicaid, Patents, Patient Experience, Patient-centered Medicine, Prescription Drugs Costs, Uncategorized, tagged advocacy, Cancer Care, cancer patient management, cancer survivor, exceeding patient expectations, health advocacy, health costs, healthcare, survivorship on July 11, 2018| Leave a Comment »

Live Conference Coverage @Medcity Converge 2018 Philadelphia: Oncology Value Based Care and Patient Management

Reporter: Stephen J. Williams, Ph.D.

3:15 – 4:00 PM Breakout: What’s A Good Model for Value-Based Care in Oncology?

How do you implement a value-based care model in oncology? Medicare has created a bundled payment model in oncology and there are lessons to be learned from that and other programs. Listen to two presentations from experts in the field.

Moderator: Mahek Shah, M.D., Senior Researcher, Harvard Business School @Mahek_MD
Speakers:
Charles Saunders M.D., CEO, Integra Connect
Mari Vandenburgh, Director of Value-Based Reimbursement Operations, Highmark @Highmark

Mari: Building strategic partnerships with partners focused on population based health and evidence based outcomes. they provide data analytics and consultative services. Incorporate risk based systems. also looking at ancillary segments because they see cost savings. True Performance is their flagship performance program and 11% lower ED (saving $18 million) rates and 16% lower readmissions ($200 million cost savings). Also launched the Highmark Cancer care Program with Johns Hopkins. They monitor the adherence pathways and if clinician shows good adherence they give reimbursements.

Charles: Integra is a cloud based care platform focused on oncology and urology and allow clinicians to practice value based care. Providers must now focus on total cost including ER visits, end of life and therapies (which is half of total cost in US). The actionable ways to reduce costs is by reducing ER visits. What is working? Data on reimbursements models is very accurate so practices can dig into data and find effieciencies. However most practices do not have the analytics to do this.

care navigation
care path based treatment choices
enhanced patient access and experience

What is not working

data not structured so someone has to do manual curation of records
flawed logic based on plurality of visits but physician doesn’t know who else they saw
target pricing not taking into account high prices of new therapies
lack of timely reporting either by patient or physician
insufficient reimbursements
technology limitations

4:10- 4:55 Breakout: What Patients Want and Need On Their Journey

Cancer patients are living with an existential threat every day. A panel of patients and experts in oncology care management will discuss what’s needed to make the journey for oncology patients a bit more bearable.

sponsored by CEO Council for Growth

Moderator: Amanda Woodworth, M.D., Director of Breast Health, Drexel University College of Medicine
Speakers:
Kezia Fitzgerald, Chief Innovation Officer & Co-Founder, CareAline® Products, LLC
Sara Hayes, Senior Director of Community Development, Health Union @SaraHayes_HU
Katrece Nolen, Cancer Survivor and Founder, Find Cancer Help @KatreceNolen
John Simpkins, Administrative DirectorService Line Director of the Cancer Center, Children’s Hospital of Philadelphia @ChildrensPhila

Kezia: was a cancer patient as well as her child getting treated at two different places and tough part was coordinating everything including treatments and schedules, working schedules

Katrece: had problem scheduling with oncologists because misdiagnosis and her imaging records were on CD and surgeon could not use the CD

John: the above are a common frustration among patients at a time when they don’t need the confusion. He feels cancer centers need to coordinate these services better

Sara: trying to assist people with this type of coordination is very tough even with all the resources

Kazia: she needed to do all the research on her own because big dichotomy being an adult and a pediatric patient where pediatrics get more information and patient centered care. She felt she felt burdening the physicians if she asked the same questions. How can we get more interaction with primary care physicians and feel comfortable with their interaction?

John: there is this dichotomy especially on wait times for adults is usually longer. We can also improve patient experience with counseling patients

Katrece: Just working with a patient navigator is not enough. The patient needs to take charge of their disease.

Sara: Patient communities can help as sometimes patients learn from other patients.

Amanda: in breast cancer , navigators are common but must take care they are not only people patients see after a while

John: at CHOP they also have a financial navigator. On the adult side there are on call financial navigators. Recent change of the high deductible plans are a major problem. Although new families are starting to become comfortable with the financial navigator

Katrece: guiding your children through your experience is important. It was also important for her to advocate for herself as she had three different sites of cancer care to coordinate and multiple teams to coordinate with each other

Amanda: A common theme seems to be hard trying to find the resources you need. Why is that?

Kazia: Sometimes it is hard to talk about your disease because it can be emotionally draining comforting other people who you told about the disease and they are being empathetic. Sometimes they want to keep their ‘journey’ to themselves

John: A relative kept her disease secret because she didn’t want to burden others…. a common cancer patient concern

Sara: Moderation of a social group is necessary to keep it a safe space and prevent trollers (like in Facebook support groups).

Kazia: most group members will get together and force those trollers out of the group

Katrece: alot of anxiety after treatment ends, patient feels like being dropped on the floor like they don’t get support after treatment. If there were survivorship navigators might be helpful

Amanda: for breast cancer they do a Survivor Care Package but just a paper packet, patients do appreciate it but a human coordinator would be a great idea

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