Good day Cancer Briefing readers! This week, I’ve been in Colorado at Aspen Ideas: Health, where I moderated a panel with Monica Bertagnolli, Robert Stone, and Mohit Manrao. While so much of the cancer conversation lately has focused on transformative new treatments, this discussion zeroed in on what gets lost when the spotlight is on the breaking edge.
Something the panelists brought up is that clinical trials could complete far more quickly and efficiently than they are with the technology and knowledge that people have today. A missing piece of infrastructure is large-scale and close integration of clinical and community spaces with research and development, they said.
Some of the discussion could be interpreted as targeted toward clinical research organizations (CROs). That leads us towards a discussion that’s way bigger than this newsletter. But to keep it short, CROs can manage a lot of operational pieces of clinical trials including patient recruitment and retention. Some see that as middleman work in research operations that could be cut out.
I’ll make a note of another interesting session here at Aspen Health. Dan Brillman, the director of the Center for Medicaid and CHIP services, was on a panel with others from CMS and asked a question about the Medicaid work requirement and 6 month redetermination period coming into effect starting January 1, 2027. Bertha Coombs, the moderator, called it the “Category 4 hurricane about to make landfall.”
Cancer advocates have expressed a lot of concern about this policy coming into effect, particularly after the interim guidance on work requirements came out earlier this month, tying medical frailty exemptions to patients’ ability to work. The worry, which the American Cancer Society Cancer Action Network put in a statement, was that may force cancer patients to prove they are unable to work in order to retain benefits.
On stage, Brillman said that they're working to make patients with certain ICD10 or claims codes receive automatic exemptions. The details of that are still coming, but the panelists on this session said they believed the changes their administration is making will make Americans healthier and health care more accessible. Audience members told STAT that they were fascinated with the discussion, but skeptical.
“I think they’re painting an overly optimistic picture of what they’re going to accomplish,” said Vivian Ho, a health economist from Rice University who was in the audience. “I’m really worried about Medicaid rolls.”
Anyone who has worked with claims data should know, she said, that they are a mess to work with.
