Spring 2015 Medical Directors Meeting Pre-Reads

Requested Pre-Reads

Below you’ll find the pre-reading for the ACHP Medical Directors Council meeting. These brief articles are designed to set the foundation for our discussions and will be referenced throughout the meeting to help provide perspective and guide insights.

Dr Peter Bach Explains Diminishing Returns in Cancer Drugs – American Journal of Managed Care

Dr. Peter Bach, who will lead a session at the meeting on drug costs, explains in a video how the cost of introductory cancer drugs is rapidly increasing without an increase in patient benefit.

Unlikelihood of Cure Did Not Reduce Chemo Use at End of Life – Cancer Network

A recent study found that patients with metastatic lung and colorectal cancer who understood that chemotherapy would not cure them of their cancer were no less likely to receive chemotherapy at the end of life than patients who did not understand that fact. However, these patients were more likely to enroll in hospice treatment. We will discuss this article as part of our Monday morning conversation on approaches, issues and paths forward in oncology care.

Engaging Health Care Consumers: The Lowe’s Experience-Health Affairs Blog

This article in Health Affairs explains how Lowe’s is thinking more broadly about what health care really is — not the treatment of a disease, but multi-faceted care for individuals and their families, linked with societal, behavioral, and cultural factors that shape lives and communities. This article relates to our Tuesday discussions on consumer expectations and health care innovation.

ACHP Advance Notice Call Letter

ACHP sent this call letter to Sean Cavanaugh, the Deputy Administrator and Director at CMS, regarding the 2016 methodological changes for Medicare Advantage capitation rates and Part C and Part D payment policies. The letter represents ACHP’s policy efforts in Washington, and will be referenced as part of our policy discussion on Tuesday morning.

Evolution of Quality Measures-Discern Health for ACHP

Discern Health compiled a report for ACHP that defines focus areas for measurement innovation to support a higher value health care system. The report is extensive, and while we encourage you to read it in its entirety, only the executive summary is requested reading for this meeting. This relates to our conversation on the evolution of measures.

Secondary Reading

While not required reading, these three articles directly relate to conversations during the meeting and will offer valuable background and insights.

ACHP Industry Health Care Disruptors 

ACHP compiled a summary document that examines five distinct areas of market disruption and highlights potential impacts, both positive and negative, that each may have on ACHP member plans. This relates to our conversations on consumer expectations and health care innovation.

Kaiser Permanente’s Innovation on the Front Lines – Harvard Business Review

This Harvard Business Review article profiles the work of Chris McCarthy – who will speak on Tuesday afternoon on innovation at Kaiser Permanente – and details his work with  Innovation Consultancy, a small team within Kaiser Permanente that was born of the company’s involvement with the design firm IDEO.

Indication Specific Pricing for Cancer Drugs – JAMA

Dr. Peter Bach argues that the price of cancer drugs should be linked to its benefits, and that the value and efficacy of cancer drugs deserves greater consideration.

Supplemental Reading

The below articles are additional pieces authored by Dr. Peter Bach.

Why Drugs Cost So Much

The Irrational Rationale for Cancer Drug Prices

Moment of Truth: Gilead Comes to Pricing Decision Point

Doctors Expose Cancer Drugs Scandal

Could High Drug Prices Be Bad for Innovation?

Cancer: Unpronounceable Drugs, Incomprehensible Prices

Dr Peter B. Bach Outlines Framework for Tying Price of Cancer Drugs to Indication, Value