CMS policies on CAR T-cell therapy present clinical and financial challenges over data gaps and data sharing as well as gaps with Medicaid reimbursement for inpatient and outpatient services. With only three CAR-T therapies in the US Market to date, what needs to happen to ensure ideal clinical and financial outcomes for all stakeholders?
Dr. Richard Stefanacci and Matthew Pakizegee, PharmD, discuss the government, policy and systems changes affecting clinical pathways in a May 2019 Journal of Clinical Pathways article titled: CMS Policies Concerning CAR T-Cell Therapy.
DO, MGH, MBA, AGSF, CMD, Chief Medical Director, Managed Markets
Richard has focused his career on improving health outcomes, especially for some of the most vulnerable populations. This has been achieved through several avenues, beginning with his continued active role as a treating internist/geriatrician. He has also put this focus into practice as chief medical officer for several management care plans, including ElderHealth/Bravo/HealthSpring/Cigna and PACE […]
Medical Associate, Government Policy Systems, Managed Markets
Matthew supports clinical services and leads clinical content for Government Policy Systems (GPS). He facilitates discussions with EVERSANA’s bench of payer consultants and manages government policy content including topics impacting healthcare delivery systems. He has held a variety of roles in biopharma, some of which include landscape analyses in oncology, advisory boards for respiratory and […]