Chet Burrell on How Trapelo Will Help Payers Manage the Growth of Precision Oncology to Improve Member Care and Lower Costs

07/25/19

In this episode, Mr. Chet Burrell, former president and CEO of Care First Blue Cross Blue Shield and Executive Chairman of the Intervention Insights Board of Directors, discusses the challenges payers face in managing the growth of precision medicine for cancer care and why he's championing Trapelo's precision diagnostic platform as the first collaborative technology solution.

How Payers Can Better Manage Precision Oncology - Mr. Chet Burrell
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Listen to the full episode above and download the full PDF transcript here.
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Mr. Burrell points out that there are now nearly tens of thousands of diagnostic tests and genetic molecular tests and it is becoming impossible for oncologists to keep up. How can they know that they are ordering the right molecular tests and whether or not those tests are tied to clinically-valid, evidence-based treatments?

 

Complicating this decision-making process is the need for payers to authorize those tests and the ensuing treatments, and it is not always easy for payers to do. Mr. Burrell notes that 2% to 3% of acutely ill patients, many of whom have cancer, account for 30% to 40% of healthcare costs. And drug costs alone have risen to become a third of all costs and rapidly rising. Payers must find a way to cover medically necessary tests and treatments, and it is usually through rising premiums. So, on the one hand, payers have providers and patients clamoring for the best treatments, and, on the other side, they have individuals and businesses complaining that healthcare coverage has become unaffordable. What can payers do?

Mr. Burrell believes one answer is to assure that the tests run are actionable and will produce valid results and that oncologists are applying treatments that are connected to the results of those tests. He says that excluding coverage or blocking coverage is not as effective as establishing a record of evidence-based treatment decisions.

 

We asked Mr. Burrell whether prior authorization is as challenging for payers as it is for providers and patients, and he says it definitely is because there is so much back and forth with providers and patients about what is seen as medically necessary and what is actually evidence-based.

 

Mr. Burrell believes technologies like Trapelo can help smooth that process and deliver cost-savings along the way.

Mr. Burrell’s extensive, cross-sector experience in healthcare makes this episode invaluable to those caught in the middle between oncology patient care and healthcare reform.

 

Listen to the full episode above to hear his perspective on what’s happening in precision medicine today and how payers and providers can start using technology as a solution for more precise cancer care and cost management.

Download the full transcript of the episode here (pdf).

 

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About Our Guest

Chet Burrell is the founder and managing member of Silavon Healthcare Holdings, where he oversees highly selective investments in U.S healthcare companies that are believed to offer both high social-impact value and high investment value. 

 

Over the last 40 years, Mr. Burrell has held numerous CEO-level positions and Chairmanship roles in both the public and private sectors of the U.S. healthcare system. He has been the acting President/CEO of three different Blue Cross/Blue Shield plans, including the largest private payer and health benefits management company in the mid-Atlantic area, CareFirst Blue Cross Blue Shield.

 

Through much of his career, Mr. Burrell has led pioneering efforts to reform financing approaches to healthcare, such as financial incentives for providers and value-based payment models to reward more cost-effective, higher-quality care.  Mr. Burrell has also supported joint efforts between U.S. government policymakers and regulators to find solutions to unaffordable healthcare costs. As a board member at Intervention Insights, he aims to make an equally powerful impact on the cost-effective use of precision oncology.

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