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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Medicare Part D 2025 Reduces Out-of-Pocket Costs for Oral Prostate Cancer Treatments
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David Morris, MD, FACS
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| Ruchika Talwar interviews David Morris about changes in 2025 for Medicare Part D resulting from the Inflation Reduction Act (IRA). Dr. Morris discusses how these changes benefit prostate cancer patients and all Medicare recipients who have Medicare Part D coverage.
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| Advanced Prostate Cancer: Understanding Out-of-Pocket Medication Costs |
| Daniel Joyce, MD, MS |
| Daniel Joyce discusses the financial impact of advanced prostate cancer treatments on patients. He presents research showing significant out-of-pocket costs for oral cancer therapies, particularly for commercially insured patients. |
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Cancer-Related Financial Hardship Among Cancer Survivors: Research from the HINTS-SEER Survey
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Apoorv Dhir, MD, and Rishi Sekar, MD, MS
Ruchika Talwar interviews Apoorv Dhir and Rishi Sekar about their study on cancer-related financial hardship among cancer survivors. The researchers discuss findings from the HINTS-SEER survey, which reveals that 44% of cancer patients report some level of financial hardship.
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| Determinants of Financial Toxicity in Patients with Urologic Cancer |
| Apoorv Dhir, MD |
| Apoorv Dhir presents the findings on financial toxicity in urologic cancer patients, highlighting the economic strain caused by treatment costs. Using data from 348 patients, the study revealed that 42% had depleted their assets within two years of diagnosis, and 38% faced insolvency after four years. The analysis showed that younger age, lower income, and lower education levels were associated with higher financial toxicity, with females experiencing more financial distress than males. |
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| State of the Art Lecture: Digital Discounts for Urology Patients: Online Tools to Decrease Out-of-Pocket Prescription Costs
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| Ruchika Talwar, MD
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| Ruchika Talwar delivers a lecture on online tools to help urology patients reduce out-of-pocket prescription costs. She discussed resources such as Medicare Part D Plan Finder, the Mark Cuban Cost Plus Drug Company, Amazon Pharmacy, and GoodRx. These platforms offer ways to lower drug expenses, especially for patients with high cost-sharing plans. Dr. Talwar emphasized the potential savings and benefits of using these tools, as well as the importance of provider awareness to guide patients in managing their prescription costs effectively.
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| Medicare Payment Reform: Fixing Physician Pay Now and for the Future |
| Jonathan Rubenstein, MD |
| Jonathan Rubenstein highlights that physician payment, unlike other Medicare reimbursements, is not inflation-adjusted, putting financial pressure on practices, especially those serving Medicare patients. Erika Miller advocated for Congress to resolve the 2024 payment conversion factor and implement structural reforms, such as inflationary adjustments via the Medicare Economic Index. |
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| The AMA's Vital Advocacy Initiatives for Physicians |
| Ruchika Talwar, MD |
| At the 2024 AMA Annual Meeting, key advocacy initiatives were highlighted, including reforms in prior authorization, physician burnout, and Medicare payment systems. The AMA achieved significant progress, including a CMS rule to streamline prior authorizations and publicize program metrics, as well as the reintroduction of the GOLD CARD Act to exempt compliant physicians from certain Medicare Advantage requirements. |
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| Evaluating the Role of Telemedicine in Reducing Racial and Ethnic Disparities in Prostate Cancer Care |
| Khalid Alkhatib, MD, MMSc |
| Khalid Alkhatib presented a study evaluating telemedicine's role in reducing racial and ethnic disparities in prostate cancer care. The study analyzed data from the National Health Interview Survey during the COVID-19 pandemic and found that prostate cancer patients were more likely to use telemedicine, with a relative risk of 1.28. While initial findings showed that Non-Hispanic Blacks were less likely to access telemedicine compared to Non-Hispanic Whites, this disparity disappeared after adjusting for multiple demographic factors, suggesting telemedicine could help equalize care access in prostate cancer treatment. |
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| CMS Releases Final Rule to Broaden Access to Health Data and Improve Prior Authorization |
| Ruchika Talwar, MD |
| In January 2024, the Centers for Medicare & Medicaid Services (CMS) released the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F), aimed at improving healthcare data exchange and streamlining the prior authorization (PA) process. This rule applies to Medicare Advantage, Medicaid, CHIP programs, and Qualified Health Plans, requiring them to enhance digital health data exchange and reduce the burdens of prior authorization for patients, providers, and payers. The changes are expected to save an estimated $15 billion over ten years. |
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