Divya Gupta, MD, of the Stanford Cancer Center, discusses an intervention utilizing a computer model and lay care coaches to improve advance care planning conversations with patients who have metastatic cancer. The study, Dr. Gupta reports, showed a trend toward less intensive care for patients at the end of life.
Morgan R.L. Lichtenstein, MD, of Columbia University Medical Center, discusses a single-center prospective study examining the complex relationship between time to oral oncolytic receipt and clinical or process-related factors, such as prior authorization, diagnosis, and insurance type.
Aakash Desai, MPH, MD, of the Mayo Clinic in Rochester, Minnesota, talks about the urgent need for drug pricing reform, given the average expenditure of Medicare part D, and the ultimate out-of-pocket costs for patients with cancer. The promise of precision oncology will fail, says Dr. Desai, if we fail to bring the right drugs to the right patient at the right time, with the right price.
Leticia Nogueira, PhD, MPH, of the American Cancer Society, discusses results from a study designed to evaluate the impact of Medicaid expansion under the Affordable Care Act (ACA). In Medicaid-expansion states, mortality among patients after lung cancer surgery decreased from 2.4% before the ACA to 0.8% after the ACA, with no significant change in non–Medicaid-expansion states.
John V. Cox, DO, MBA, of The University of Texas Southwestern Medical Center, summarizes his Joseph V. Simone Lecture, in which he stressed the need for coordinated care among practices. The concept of oncology medical homes, he says, has evolved to a broader-based model in which oncologists cooperate with other practices to manage patients and their comorbidities with optimal outcomes. Professional organizations such as the American College of Physicians and ASCO can provide clinicians with the tools they need to engage in this future of health care.
Divya A. Parikh, MD, of Stanford University School of Medicine, discusses findings that suggest an evidence-based tool, the Serious Illness Conversation Guide, may engage patients with metastatic or recurrent urologic cancer in goals-of-care conversations, potentially resulting in an increase of documentation of their goals in the electronic medical record.
