A Timely & Packed Agenda

COA’s Payer Exchange Summit will examine different proven employer and provider designed programs and discuss how they can best promote successful models at the local level that provide value-based, continually improving quality cancer care.

Attendees will hear from national experts with updates on issues such as value-based contracting, innovative payment models, new strategies to increase quality and value, and novel interventions to support employees with cancer.

Sessions and times subject to change.

Note: All times are Eastern Daylight Time (EDT)

Monday, October 25, 2021

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12:00 – 12:55 PM

Welcome & Rapid-Fire Review of the State of Oncology Reform
Opening remarks and a fast-paced glimpse of oncology reform initiatives.
   • Michael Diaz, MD, Director of Patient Advocacy & Assistant Managing Physician, Florida Cancer Specialists &
     Research Institute

   • Bo Gamble, Director of Strategic Practice Initiatives, Community Oncology Alliance, Moderator
   • Lalan Wilfong, MD, Vice President, Payer Relations & Practice Transformation, McKesson Specialty Health

1:00 – 1:40 PM

Study: Are Hospitals Fueling the Cost of Cancer Care?
Dive into the results of COA’s recent analysis of hospital prices for oncology drugs and 340B Drug Pricing Program discounts.
   • Aharon “Ronny” Gal, PhD, Moto Bioadvisors

1:45 – 2:25 PM

Pharmaceutical Manufacturers’ Drug Pricing Transparency
Hear from a panel of leading manufacturers who provide their perspectives on list prices, discounts, and market net prices.
   • Patrick Davish, Associate Vice President, Merck & Co, Inc.
   •
Ted Okon, MBA, Executive Director, Community Oncology Alliance, Moderator
   •
John Reuland, Leader, Access Communication, Johnson & Johnson

2:30 – 3:10 PM

Increasing Impact of Pharmacy Benefit Managers (PBMs) on Cancer Care
PBMs continue to play an important role as middlemen between oncologists and their patients. How is this impacting cancer care?
   • Jonathan E. Levitt, Esq., Founding Partner, Frier Levitt

3:15 – 3:55 PM

Prior Authorization: Clinical Oversight or Obstacles to Care?
A discussion on proper – and improper – uses of prior authorizations, step therapy, and related payer utilization management strategies.
   • Melissa Austin, Supervisor Revenue Cycle, Cancer Care Centers of Brevard
   •
Andrew Hertler, MD, FACP, Chief Medical Officer, New Century Health, Moderator
   •
Gary Kay, MD, Northwest Oncology & Hematology, S.C.
   •
Bryan Loy, MD, Physician Lead, Oncology, Laboratory, & Personalized Medicine, Humana

4:00 – 4:40 PM

Analysis: Are Biosimilars Meeting the Promise of Increasing Competition & Lowering Cancer Drug Costs?
Separating the fact from fiction of biosimilars, hear the results of an analysis of COA members’ use and perspective of biosimilars in oncology.
   • E. Randolph “Randy” Broun, MD, Physician Partner, Blood & Marrow Transplant Specialist, OHC
   •
Kathy Oubre, MS, Chief Executive Officer, Pontchartrain Cancer Center

4:45 – 5:30 PM

State Leadership in Pharmacy Benefit Manager (PBM) Reforms
A review of recent state laws and policy changes to curtail PBM abuses.
   •
Nicolas Ferreyros, Director of Communications, Community Oncology Alliance, Moderator
   •
Representative David Knight, Georgia House of Representatives, R-Georgia
   •
Debra Patt, MD, PhD, MBA, Vice President, Texas Oncology & US Oncology
   •
Stephen Schleicher, MD, MBA, Medical Director, Value Based Care, Tennessee Oncology, OneOncology,
     President, Tennessee Oncology Practice Society

5:30 – 5:35 PM

Closing Remarks

Tuesday, October 26, 2021

8:30 – 9:25 AM

The NEW Oncology Medical Home (OMH) Certification & Pilot Program
This summer, COA and ASCO launched a NEW OMH certification and pilot program to identify, promote, and support high-quality cancer care.
   • Bo Gamble, Director of Strategic Practice Initiatives, Community Oncology Alliance, Moderator
   •
Stephen Grubbs, MD, FASCO, Vice President, Care Delivery, American Society of Clinical Oncology
   •
Amy King, Administrator, Nebraska Hematology-Oncology
   • Teresa Molina, Program Design Manager, Specialty Collaborative Care, Cigna
   •
Dennis Zoet, Chief Business Development Officer, Cancer & Hematology Centers of Western Michigan, P.C.

9:30 – 10:15 AM

Is There a Practical Role for Value-Based Insurance (V-BID) in Cancer Care?
V-BID has found its application in encouraging the use of high-value preventative services. Can it be applied to cancer care and how?
   • A. Mark Fendrick, MD, Director, Center for Value-Based Insurance Design, University of Michigan

10:20 – 11:10 AM

Direct Contracting in Oncology
Is direct contracting between oncology providers and employers a possible new model for the future of cancer care?
   • Elizabeth Mitchell, President, Chief Executive Officer, Purchaser Business Group on Health
   •
Ted Okon, MBA, Executive Director, Community Oncology Alliance

11:15 AM – 12:00 PM

Increasing Engagement of Self-Insured Employers in Oncology Contracting
158 million Americans (49.6%) are covered by employer sponsored insurance. How can we better engage with self-insured employers to promote quality and value in cancer care?
   • Robert Baird, Jr., RN, MSA, President, National Cancer Treatment Alliance, Cancer Pharmacy Network,
     
Moderator
   •
Glenn Balasky, Executive Director, Rocky Mountain Cancer Centers
   •
Marcus Garcia, Senior Director Payer & Strategy Relations, Rocky Mountain Cancer Centers
   •
Robert J. Smith, MBA, Executive Director, Colorado Business Group on Health

12:00 – 12:30 PM

Lunch Break

12:30 – 1:10 PM

Measuring the Patient Experience & Outcomes in Cancer Care
A look at the importance of electronic patient-reported outcomes (ePROs) and measures of treatment satisfaction; and a new COA and PBGH collaboration.
   • Rachel DuPré Brodie, Senior Director, Measurement & Accountability, Purchaser Business Group on Health
   •
Bo Gamble, Director of Strategic Practice Initiatives, Community Oncology Alliance, Moderator
   •
Lynn Kay Winters, Chief Quality & Learning Officer, New York Cancer & Blood Specialists

1:15 – 2:00 PM

Understanding & Addressing Disparities in Cancer Care: A Frank Conversation
A panel discussion on practical, patient-centered solutions for oncology practices to address disparities in cancer screenings, treatment, and more.
   • Barbara L. McAneny, MD, Chief Executive Officer, New Mexico Oncology Hematology Consultants, Ltd.
   •
Alti Rahman, MHA, MBA, CSSBB, Practice Administrator, Oncology Consultants, Moderator
   •
Susan Sabo-Wagner, RN, BSN, OCN, Clinical Director, Oncology Consultants

2:05 – 3:00 PM

Where is CMS & Its Innovation Center with Oncology Payment Reform
A review of the various oncology payment models CMS is implementing, or considering, to change the reimbursement for Medicare drugs and services.
   • Ted Okon, MBA, Executive Director, Community Oncology Alliance

3:00 – 3:05 PM

Closing Remarks