Don’t look now but a consensus that bundled payments is the best payment reform strategy is emerging, and it’s expected that many pilot and demonstration projects will start soon. And while orthopedic and cardiac procedures are getting the most attention from the Centers for Medicare and Medicaid Services (CMS) for now, it looks like oncology is not far behind.
And why not? Annual spending for cancer treatment in the United States is set to reach $184 billion by 2020. The large and growing bill has raised concerns that fee-for-service payments for oncology are promoting over-treatment and use of more expensive drugs irrespective of patient benefit. With cancer rates projected to rise steeply in the next two decades, this is a critical time to improve efficiency and standardize quality in oncology services, and many see episode-based bundled payments as a promising strategy.
Two recent webinars addressed this issue.
A recent webinar
, hosted by the NIHCM Foundation and the Center for American Progress, addressed the issue of bundled payments from an oncology perspective. The NIHCM Foundation is a nonprofit, nonpartisan research and educational foundation dedicated to improving the effectiveness, efficiency and quality of the U.S. health care system.
The webinar addressed the latest cost and quality issues in oncology, including missed opportunities in care coordination and end-of-life care; an overview of the framework for episodic payment bundles developed by a consortium of oncologists, public and private payers, and patient groups; the use of bundled payments in Medicare, and how CMS might approach reforming payment for oncology services; and an payer collaboration with a leading oncology provider group to develop episodes of care with an focus on improving quality.
At another recent webinar
, the chief medical officer for CMS, Patrick Conway, MD, and Erin Smith, CMS’ point person for new payment methods for specialty care, shared CMS’ current thinking about a new oncology care model. During the webinar, the duo said the goal of an oncology model for payment reform would be to utilize appropriately aligned financial incentives to improve care coordination, determine appropriateness of care, and ensure beneficiaries have access to chemotherapy.
Payment reform is just around the corner and soon pilot programs will be launched to determine in what form these changes should be in. Stay tuned as this is a quickly changing landscape.