|By Marketwired .||
|March 19, 2014 11:15 AM EDT||
FORT WASHINGTON, PA--(Marketwired - March 19, 2014) - On Friday, March 14, 2014, the National Comprehensive Cancer Network® (NCCN®) hosted its second roundtable of the NCCN 19th Annual Conference: Advancing the Standard of Cancer Care™, titled, The Affordable Care Act: Where are We Now? Clifford Goodman, PhD, The Lewin Group, moderated the discussion, which explored the Affordable Care Act (ACA) and health care reform in the United States, its effect on the oncology landscape, and assessment of risk for providers, payers, and patients.
Dr. Goodman was joined by Christian G. Downs, JD, MHA, Association of Community Cancer Centers; Liz Fowler, PhD, JD, Johnson & Johnson; Michael Kolodziej, MD, Aetna; Lee H. Newcomer, MD, MHA, UnitedHealthcare; John C. Winkelmann, MD, Oncology Hematology Care, Inc., and Councillor, American Society of Hematology; Mohammed S. Ogaily, MD, Henry Ford Health System; and W. Thomas Purcell, MD, MBA, University of Colorado Cancer Center.
Dr. Goodman opened Friday's roundtable discussion by asking Dr. Purcell how, since the implementation of the ACA, patients have been presenting differently than in previous years.
Dr. Purcell described how, at University of Colorado Cancer Center, two distinct groups have presented since the ACA: medically indigent adults and newly underinsured patients who, for the first time, are within a narrow network and do not have the same access to comprehensive care that was previously available through employer-sponsored programs. These groups, he said, now qualify for Medicaid or have purchased Bronze Packages; however, both are accompanied by large co-pays.
Due to the well-run state exchange and Medicaid expansion in Kentucky, said Dr. Winkelmann, adult patients are, for the first time in years, seeing their primary care physicians. In turn, he said, oncologists are experiencing an influx of newly insured patients because they have undergone overdue routine cancer screening.
Patients who recently acquired health care and who have been putting off treatment are now presenting with complex cases that require an immediate need, added Dr. Ogaily.
Dr. Fowler and Mr. Downs explained that this poses risk in oncology because, when the ACA was first implemented, young, healthy patients (less than 35 years old) were expected to sign up in multitudes. To the contrary, Mr. Downs added, a risk pool has emerged as the majority of new enrollees are around the age of 55, and this demographic is more likely to have cancer, require expensive treatment, and carry other comorbidities.
Dr. Goodman asked Dr. Kolodziej and Dr. Newcomer how, as payers, they are assessing their risk with more patients requiring more expensive care.
Drs. Kolodziej and Newcomer agreed that, given the fact that the market has been open for less than 90 days, the necessary claims data is not available to adjust premiums.
"We are trying to understand how the process works," said Dr. Newcomer. "And, then we are ready to get fully committed and expand as soon as we understand how it's going to work."
"Given the uncertainty, you manage what you can manage," said Dr. Kolodziej. "Many of the strategies to manage the risk of this unknown pool are the same strategies we use to manage the risk in the pool that we do know about."
"If the risk pool stays risky, does it all fall apart?" Dr. Goodman asked Dr. Fowler.
"Congress and the public need to think about what adjustments they need to make," said Dr. Fowler, who, prior to her employment at Johnson & Johnson, worked with the U.S. Senate and at the White House on the authoring and implementation of the legislature. Dr. Fowler explained that there are three mechanisms for self-correction -- referred to as the premium stabilization programs -- built into the law to make amends for enrolling sick people up front: the temporary reinsurance program, the temporary risk corridor program, and permanent risk adjustment.
According to the panel, risk is not only eminent for payers and providers, but also for patients. Quality of care is a major concern for patients with rare diseases, explained Dr. Purcell. Because patients with rare cancers require state-of-the-art treatment that is not always available in the community setting, they seek care at larger, academic centers that are not covered within their narrow markets, and these patients are forced to pay for their care out of pocket.
And, with more and more community oncology practices being purchased by larger hospitals, financial risk is eminent for patients, said Dr. Ogaily. Trying to work through a hospital is more difficult and more time consuming, therefore, raising administrative costs, he said, adding that those costs are transitioned to the patients.
Further, if a community practice is purchased by a hospital, said Dr. Newcomer, payers are seeing as much as a 10-fold rise in drug costs. Patients, then, make up for the rise in cost through co-pays and deductibles, and the provider pays the difference, he explained.
"We can all agree that there is a lack of transparency and this discussion degenerates into a qualitative versus a quantitative argument," said Dr. Kolodziej. "The solution is shifting risk."
"What we need to do, collaboratively, is work on reducing administrative expenses," said Dr. Newcomer. "It's going to take discussions, it's going to take experiments, and it's going to take a blank piece of paper."
In closing, Dr. Goodman asked the panel to discuss what they believe the keys for successful implementation of the law will be. The answers: integrated care, payment reform, and an increased focus on value and quality.
About the National Comprehensive Cancer Network
The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 25 of the world's leading cancer centers devoted to patient care, research, and education, is dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers.
The NCCN Member Institutions are: Fred and Pamela Buffett Cancer Center at The Nebraska Medical Center, Omaha, NE; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Cancer Institute, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Mayo Clinic Cancer Center, Phoenix/Scottsdale, AZ, Jacksonville, FL, and Rochester, MN; Memorial Sloan-Kettering Cancer Center, New York, NY; Moffitt Cancer Center, Tampa, FL; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, OH; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center, Memphis, TN; Stanford Cancer Institute, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UC San Diego Moores Cancer Center, La Jolla, CA; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Colorado Cancer Center, Aurora, CO; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; The University of Texas MD Anderson Cancer Center, Houston, TX; Vanderbilt-Ingram Cancer Center, Nashville, TN; and Yale Cancer Center/Smilow Cancer Hospital, New Haven, CT.
The following files are available for download:
Katie Kiley Brown, NCCN
DevOps is often described as a combination of technology and culture. Without both, DevOps isn't complete. However, applying the culture to outdated technology is a recipe for disaster; as response times grow and connections between teams are delayed by technology, the culture will die. A Nutanix Enterprise Cloud has many benefits that provide the needed base for a true DevOps paradigm.
Feb. 27, 2017 11:45 PM EST Reads: 888
You think you know what’s in your data. But do you? Most organizations are now aware of the business intelligence represented by their data. Data science stands to take this to a level you never thought of – literally. The techniques of data science, when used with the capabilities of Big Data technologies, can make connections you had not yet imagined, helping you discover new insights and ask new questions of your data. In his session at @ThingsExpo, Sarbjit Sarkaria, data science team lead ...
Feb. 27, 2017 11:00 PM EST Reads: 9,158
Ayehu provides IT Process Automation & Orchestration solutions for IT and Security professionals to identify and resolve critical incidents and enable rapid containment, eradication, and recovery from cyber security breaches. Ayehu provides customers greater control over IT infrastructure through automation. Ayehu solutions have been deployed by major enterprises worldwide, and currently, support thousands of IT processes across the globe. The company has offices in New York, California, and Isr...
Feb. 27, 2017 10:45 PM EST Reads: 799
Tintri VM-aware storage is the simplest for virtualized applications and cloud. Organizations including GE, Toyota, United Healthcare, NASA and 6 of the Fortune 15 have said "No to LUNs." With Tintri they manage only virtual machines, in a fraction of the footprint and at far lower cost than conventional storage. Tintri offers the choice of all-flash or hybrid-flash platform, converged or stand-alone structure and any hypervisor. Rather than obsess with storage, leaders focus on the business app...
Feb. 27, 2017 10:15 PM EST Reads: 700
Addteq is one of the top 10 Platinum Atlassian Experts who specialize in DevOps, custom and continuous integration, automation, plugin development, and consulting for midsize and global firms. Addteq firmly believes that automation is essential for successful software releases. Addteq centers its products and services around this fundamentally unique approach to delivering complete software release management solutions. With a combination of Addteq's services and our extensive list of partners,...
Feb. 27, 2017 10:00 PM EST Reads: 1,299
The Internet of Things will challenge the status quo of how IT and development organizations operate. Or will it? Certainly the fog layer of IoT requires special insights about data ontology, security and transactional integrity. But the developmental challenges are the same: People, Process and Platform and how we integrate our thinking to solve complicated problems. In his session at 19th Cloud Expo, Craig Sproule, CEO of Metavine, demonstrated how to move beyond today's coding paradigm and sh...
Feb. 27, 2017 09:15 PM EST Reads: 4,174
Big Data, cloud, analytics, contextual information, wearable tech, sensors, mobility, and WebRTC: together, these advances have created a perfect storm of technologies that are disrupting and transforming classic communications models and ecosystems. In his session at @ThingsExpo, Erik Perotti, Senior Manager of New Ventures on Plantronics’ Innovation team, provided an overview of this technological shift, including associated business and consumer communications impacts, and opportunities it m...
Feb. 27, 2017 08:00 PM EST Reads: 7,965
WebRTC is about the data channel as much as about video and audio conferencing. However, basically all commercial WebRTC applications have been built with a focus on audio and video. The handling of “data” has been limited to text chat and file download – all other data sharing seems to end with screensharing. What is holding back a more intensive use of peer-to-peer data? In her session at @ThingsExpo, Dr Silvia Pfeiffer, WebRTC Applications Team Lead at National ICT Australia, looked at differ...
Feb. 27, 2017 07:45 PM EST Reads: 7,383
For organizations that have amassed large sums of software complexity, taking a microservices approach is the first step toward DevOps and continuous improvement / development. Integrating system-level analysis with microservices makes it easier to change and add functionality to applications at any time without the increase of risk. Before you start big transformation projects or a cloud migration, make sure these changes won’t take down your entire organization.
Feb. 27, 2017 07:45 PM EST Reads: 1,634
With major technology companies and startups seriously embracing IoT strategies, now is the perfect time to attend @ThingsExpo 2016 in New York. Learn what is going on, contribute to the discussions, and ensure that your enterprise is as "IoT-Ready" as it can be! Internet of @ThingsExpo, taking place June 6-8, 2017, at the Javits Center in New York City, New York, is co-located with 20th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry p...
Feb. 27, 2017 07:30 PM EST Reads: 2,267
SYS-CON Events announced today that IoT Now has been named “Media Sponsor” of SYS-CON's 20th International Cloud Expo, which will take place on June 6–8, 2017, at the Javits Center in New York City, NY. IoT Now explores the evolving opportunities and challenges facing CSPs, and it passes on some lessons learned from those who have taken the first steps in next-gen IoT services.
Feb. 27, 2017 07:15 PM EST Reads: 1,994
The Internet of Things can drive efficiency for airlines and airports. In their session at @ThingsExpo, Shyam Varan Nath, Principal Architect with GE, and Sudip Majumder, senior director of development at Oracle, discussed the technical details of the connected airline baggage and related social media solutions. These IoT applications will enhance travelers' journey experience and drive efficiency for the airlines and the airports.
Feb. 27, 2017 07:00 PM EST Reads: 2,607
SYS-CON Events announced today that WineSOFT will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Based in Seoul and Irvine, WineSOFT is an innovative software house focusing on internet infrastructure solutions. The venture started as a bootstrap start-up in 2010 by focusing on making the internet faster and more powerful. WineSOFT’s knowledge is based on the expertise of TCP/IP, VPN, SSL, peer-to-peer, mob...
Feb. 27, 2017 07:00 PM EST Reads: 2,219
DevOps is being widely accepted (if not fully adopted) as essential in enterprise IT. But as Enterprise DevOps gains maturity, expands scope, and increases velocity, the need for data-driven decisions across teams becomes more acute. DevOps teams in any modern business must wrangle the ‘digital exhaust’ from the delivery toolchain, "pervasive" and "cognitive" computing, APIs and services, mobile devices and applications, the Internet of Things, and now even blockchain.
Feb. 27, 2017 06:45 PM EST Reads: 2,269
A strange thing is happening along the way to the Internet of Things, namely far too many devices to work with and manage. It has become clear that we'll need much higher efficiency user experiences that can allow us to more easily and scalably work with the thousands of devices that will soon be in each of our lives. Enter the conversational interface revolution, combining bots we can literally talk with, gesture to, and even direct with our thoughts, with embedded artificial intelligence, whic...
Feb. 27, 2017 06:30 PM EST Reads: 2,150