Julia R. Trosman
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View article: Implementation of Cancer Genomics in the United States: Views of Payers and Other Stakeholders on Challenges and the Role of Payers in Solutions
Implementation of Cancer Genomics in the United States: Views of Payers and Other Stakeholders on Challenges and the Role of Payers in Solutions Open
PURPOSE Genomic testing is crucial in cancer risk identification, diagnosis, and treatment. However, health care implementation is challenging, even for tests covered by insurance. US payers are important health care participants and may c…
View article: Oncologic drug repository programs in the United States: a review and comparison
Oncologic drug repository programs in the United States: a review and comparison Open
As cancer affects 40% of all Americans during their lifetime, the financial burden of cancer care represents a significant contribution towards the overall cost of health care in the United States. Cancer drug repository programs offer a u…
View article: Developing the 4R model for care delivery, coordination, and patient and their care partners self‐management for suspected or diagnosed Alzheimer’s disease and related dementias
Developing the 4R model for care delivery, coordination, and patient and their care partners self‐management for suspected or diagnosed Alzheimer’s disease and related dementias Open
The incidence of Alzheimer’s disease and related dementias (ADRD) is on the rise, but diagnoses are frequently delayed, and treatment options are limited. Nevertheless, systematic care protocols and plans of action for patients and their c…
View article: MA05.05 Patient Reported Experience as a Baseline for 4R Care Sequence Implementation at 8 Cancer Centers
MA05.05 Patient Reported Experience as a Baseline for 4R Care Sequence Implementation at 8 Cancer Centers Open
View article: Perspectives of private payers on multicancer early-detection tests: informing research, implementation, and policy
Perspectives of private payers on multicancer early-detection tests: informing research, implementation, and policy Open
Emerging blood-based multicancer early-detection (MCED) tests may redefine cancer screening, reduce mortality, and address health disparities if their benefit is demonstrated. U.S. payers’ coverage policies will impact MCED test adoption a…
View article: Advance Directives for Patients With Breast Cancer: Applying the Right Info/Right Care/Right Patient/Right Time Oncology Model
Advance Directives for Patients With Breast Cancer: Applying the Right Info/Right Care/Right Patient/Right Time Oncology Model Open
Background Advance directives (AD) are an important component of life care planning for patients undergoing treatment for cancer; however, there are few effective interventions to increase AD rates. In this quality improvement project, the…
View article: Resource and Reimbursement Barriers to Comprehensive Cancer Care Delivery: An Analysis of Association of Community Cancer Centers Survey Data
Resource and Reimbursement Barriers to Comprehensive Cancer Care Delivery: An Analysis of Association of Community Cancer Centers Survey Data Open
PURPOSE: Comprehensive cancer care (CCC) delivery is recommended in guidelines and considered essential for high-quality cancer management. Barriers, such as insufficient reimbursement, prevent consistent access to and delivery of CCC. Ass…
View article: A Learning Health System Approach to Cancer Survivorship Care Among LGBTQ+ Communities
A Learning Health System Approach to Cancer Survivorship Care Among LGBTQ+ Communities Open
PURPOSE: Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals who receive primary care services at community health centers are often referred to external specialty care centers after cancer diagnosis, upon which primary car…
View article: Fostering a High-Functioning Team in Cancer Care Using the 4R Oncology Model: Assessment in a Large Health System and a Blueprint for Other Institutions
Fostering a High-Functioning Team in Cancer Care Using the 4R Oncology Model: Assessment in a Large Health System and a Blueprint for Other Institutions Open
PURPOSE: Delivering cancer care by high-functioning multidisciplinary teams promises to address care fragmentation, which threatens care quality, affects patient outcomes, and strains the oncology workforce. We assessed whether the 4R Onco…
View article: Genetic counselors' experience with reimbursement and patient out‐of‐pocket cost for multi‐cancer gene panel testing for hereditary cancer syndromes
Genetic counselors' experience with reimbursement and patient out‐of‐pocket cost for multi‐cancer gene panel testing for hereditary cancer syndromes Open
Multi‐cancer gene panels for hereditary cancer syndromes (hereditary cancer panels, HCPs) are widely available, and some laboratories have programs that limit patients' out‐of‐pocket (OOP) cost share. However, little is known about practic…
View article: Assessing Breast Cancer Risks to Improve Care for an Increased-Risk Population within Eastern North Carolina
Assessing Breast Cancer Risks to Improve Care for an Increased-Risk Population within Eastern North Carolina Open
BACKGROUND The average lifetime risk of breast cancer for an American woman is 12.5%, but individual risks vary significantly. Risk modeling is a standard of care for breast cancer screening and prevention with recommended tools to …
View article: 4R COVID-19 Toolkit for Patient Self-Management of Mild or Moderate COVID-19 symptoms
4R COVID-19 Toolkit for Patient Self-Management of Mild or Moderate COVID-19 symptoms Open
There is an under-addressed need to help patients who experience mild-to-moderate COVID-19 symptoms or are asymptomatic, to manage their disease at home. While no approved COVID-19 medical treatments exist for these patients, home-based se…
View article: US private payers’ perspectives on insurance coverage for genome sequencing versus exome sequencing: A study by the Clinical Sequencing Evidence-Generating Research Consortium (CSER)
US private payers’ perspectives on insurance coverage for genome sequencing versus exome sequencing: A study by the Clinical Sequencing Evidence-Generating Research Consortium (CSER) Open
View article: Attitudes and Perceptions of Multidisciplinary Cancer Care Clinicians Toward Telehealth and Secure Messages
Attitudes and Perceptions of Multidisciplinary Cancer Care Clinicians Toward Telehealth and Secure Messages Open
In this survey of multidisciplinary cancer care clinicians in the COVID-19 era, telehealth was well received and often preferred by most cancer care clinicians, who deemed it appropriate to manage most aspects of cancer care. As telehealth…
View article: Hereditary cancer panel testing challenges and solutions for the latinx community: costs, access, and variants
Hereditary cancer panel testing challenges and solutions for the latinx community: costs, access, and variants Open
View article: Influence of payer coverage and out‐of‐pocket costs on ordering of NGS panel tests for hereditary cancer in diverse settings
Influence of payer coverage and out‐of‐pocket costs on ordering of NGS panel tests for hereditary cancer in diverse settings Open
The landscape of payment for genetic testing has been changing, with an increase in the number of laboratories offering testing, larger panel offerings, and lower prices. To determine the influence of payer coverage and out‐of‐pocket costs…
View article: Telemedicine in Oncology and Reimbursement Policy During COVID-19 and Beyond
Telemedicine in Oncology and Reimbursement Policy During COVID-19 and Beyond Open
The first confirmed case of coronavirus disease 2019 (COVID-19) in the United States was reported on January 20, 2020. As of September 17, 2020, there were more than 6.6 million confirmed cases and 196,277 deaths. Limited data are availabl…
View article: COVID-19 Pandemic and Telehealth: allergy patient perspectives in an urban, academic medical center
COVID-19 Pandemic and Telehealth: allergy patient perspectives in an urban, academic medical center Open
View article: 4R COVID-19 Toolkit for Patient Self-Management of Mild or Moderate COVID-19 symptoms
4R COVID-19 Toolkit for Patient Self-Management of Mild or Moderate COVID-19 symptoms Open
View article: Systematic Patient Navigation Strategies to Scale Breast Cancer Disparity Reduction by Improved Cancer Prevention and Care Delivery Processes
Systematic Patient Navigation Strategies to Scale Breast Cancer Disparity Reduction by Improved Cancer Prevention and Care Delivery Processes Open
PURPOSE: Patient navigation uses trained personnel to eliminate barriers to timely care across all phases of the health care continuum, thereby reducing health disparities. However, patient navigation has yet to be systematized in implemen…
View article: Payer decision making for next-generation sequencing–based genetic tests: insights from cell-free DNA prenatal screening
Payer decision making for next-generation sequencing–based genetic tests: insights from cell-free DNA prenatal screening Open
Cell-free DNA (cfDNA) prenatal screening tests have been rapidly adopted into clinical practice, in part due to positive insurance coverage. We evaluated the framework payers used in making coverage decisions to describe a process that sho…
View article: Insights From a Temporal Assessment of Increases in US Private Payer Coverage of Tumor Sequencing From 2015 to 2019
Insights From a Temporal Assessment of Increases in US Private Payer Coverage of Tumor Sequencing From 2015 to 2019 Open
View article: MA19.01 Empirical Identification of Distress Clusters in Lung Cancer Patients
MA19.01 Empirical Identification of Distress Clusters in Lung Cancer Patients Open
View article: Perspectives of US private payers on insurance coverage for pediatric and prenatal exome sequencing: Results of a study from the Program in Prenatal and Pediatric Genomic Sequencing (P3EGS)
Perspectives of US private payers on insurance coverage for pediatric and prenatal exome sequencing: Results of a study from the Program in Prenatal and Pediatric Genomic Sequencing (P3EGS) Open
View article: Emergence of Hybrid Models of Genetic Testing Beyond Direct-to-Consumer or Traditional Labs
Emergence of Hybrid Models of Genetic Testing Beyond Direct-to-Consumer or Traditional Labs Open
Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JA…
View article: New Medicare Coverage Policy for Next-Generation Tumor Sequencing: A Key Shift in Coverage Criteria With Broad Implications Beyond Medicare
New Medicare Coverage Policy for Next-Generation Tumor Sequencing: A Key Shift in Coverage Criteria With Broad Implications Beyond Medicare Open
The Centers for Medicare & Medicaid Services (CMS) recently issued a national coverage determination (NCD) on next generation tumor sequencing tests (NGTS) for patients with advanced cancer (see Box for definitions).The CMS policy provides…
View article: From the Past to the Present: Insurer Coverage Frameworks for Next-Generation Tumor Sequencing
From the Past to the Present: Insurer Coverage Frameworks for Next-Generation Tumor Sequencing Open
View article: Private payer coverage policies for exome sequencing (ES) in pediatric patients: trends over time and analysis of evidence cited
Private payer coverage policies for exome sequencing (ES) in pediatric patients: trends over time and analysis of evidence cited Open
View article: Insurance coverage for genomic tests
Insurance coverage for genomic tests Open
On 16 March, the Centers for Medicare and Medicaid Services (CMS) announced that Medicare will cover Food and Drug Administration (FDA)–approved or cleared genomic tests that encompass broad gene panels for advanced cancer patients ([ 1 ][…
View article: Payer coverage policies for multigene tests
Payer coverage policies for multigene tests Open