Value-Based Care

Significant gains in cancer research and prevention have led to longer survival, improved quality of life, and decreased disease burden. The 2015 annual report on “Clinical Cancer Advances” from the American Society of Clinical Oncology (ASCO) outlines the biggest advances made in oncology, and for the first time designates one cancer as the Advance of the Year, as well as emphasizing the ongoing challenge of value-based care.
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Hollywood, FL—Value-based decision-making at the bedside can be fraught with obstacles, with no clear agreement on what constitutes value, and for whom. In addition, the myriad insurance plans preclude uniform treatment strategies, despite clinical pathways and guidelines intended to reduce variation in care. Finally, value is becoming more difficult to achieve in oncology as each benefit becomes more expensive, with the cost of new therapies outpacing inflation.
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The Merriam-Webster dictionary defines “logistics” as the things that must be done to plan and organize a complicated activity that involves many people. The modern delivery of cancer care precisely parallels this definition.
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Chicago, IL—Oncologists should become value-based providers by eliminating unnecessary tests, prescribing cheaper alternatives when therapeutic equivalents exist, and keep calling for payment reform, said Ezekiel J. Emanuel, MD, PhD, Chair, Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, at the 2014 American Society of Clinical Oncology meeting, during a session on defining value from different stakeholder perspectives.
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The addition of lapatinib (Tykerb) to trastuzumab (Herceptin) to create dual HER2 blockade was no better than trastuzumab alone in the adjuvant treatment of patients with HER2 breast cancer in the global phase 3 ALTTO (Adjuvant Lapatinib and/or Trastuzumab Treatment Optimisation) trial, reported Martine J. Piccart-Gebhart, MD, PhD, Chair, Breast International Group, Brussels, Belgium, at a plenary session at the 2014 American Society of Clinical Oncology (ASCO) meeting.
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Blue Cross Blue Shield (BCBS) is implementing value-based care and payment models across the country to reward quality and improve outcomes, and these are amounting to billions of dollars in cost-savings and reduced hospitalizations.
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San Antonio, TX—Many new drugs are currently in development for the treatment of patients with breast cancer. The following is a selection of drugs featured at the 2013 San Antonio Breast Cancer Symposium.
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The study “Impact of oophorectomy on cancer incidence and mortality in women with a BRCA1 or BRCA2 mutation” that was recently published in the Journal of Clinical Oncology (Finch AP, et al. 2014 February 24 [Epub ahead of print]) provides an update of previous work by the same investigators on a similar population.
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Phoenix, AZ—The staff at the Mayo Clinic are working to “bend the cost curve” and optimize resource utilization efficiency while continuing to provide high-quality care to their large population of patients, said Kari Bunkers, MD, Chief Medical Information Officer, Mayo Clinic Health System, and Medical Director, Mayo Clinic Office of Population Health Management (OPHM) at the American Medical Group Association 2013 Institute for Quality Leadership conference.
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In a recent guest blog on the Harvard Business Review website, Toby Cosgrove, MD, President and CEO of the Cleveland Clinic in Ohio, suggested that value-based care represents a life-saving “breakthrough,” not unlike penicillin or decoding the human genome, by focusing on lowering costs and improving quality of care and outcomes as its main goals.
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