Application of Payment Reform Models in Oncology

Video

ASCO has proposed new payment approaches that have some flexibility, notes Jeffrey C. Ward, MD. One model, he explains, is based on a fee-for-service system, but adds patient management fees and accountability for lowering the cost of care. It has not yet been determined whether unnecessary utilization is reduced with this model.

A variation on this model incorporates a monthly bundled payment that allows for flexibility in how the care is provided. This allows practices to innovate and add other care providers to the team, such as palliative care clinicians or nurse practitioners. It also allows them to practice at the top of their licenses, says Ward.

The final model is based on an all-inclusive bundle, which can include medications or exclude them. Many practices will never be able to manage this level of risk, states Ward. Although the Centers for Medicare & Medicaid Services’s Oncology Care Model may have benefits, adds Ward, it is important to test other models as well.

Related Videos
Arya Amini, MD
Adrianna Masters, MD, PhD,
Chul Kim, MD, MPH
Andrew Ip, MD
In this final episode of OncChats: Assessing the Promise of AI in Oncology, Toufic A. Kachaamy, MD, and Douglas Flora, MD, LSSBB, FACCC, discuss a roadmap of artificial intelligence (AI) advances in the next 5 to 10 years.
In this eighth episode of OncChats: Assessing the Promise of AI in Oncology, Toufic A. Kachaamy, MD, and Douglas Flora, MD, LSSBB, FACCC, explain how artificial intelligence tools are being developed to match the right patient to the right drug on the right clinical trial.
In this seventh episode of OncChats: Assessing the Promise of AI in Oncology, Toufic A. Kachaamy, MD, and Douglas Flora, MD, LSSBB, FACCC, discuss how artificial intelligence tools may be utilized to improve wait time for treatment, to provide more time for provider-patient interactions, and more.
In this final episode of OncChats: Reviewing Best Practices in the Surgical Management of Breast Cancer, Gladys Giron, MD, FACS, and Cristina Lopez-Peñalver, MD, shed light on clinical outcomes following surgery of the primary tumor in patients with stage IV breast cancer.
In this sixth episode of OncChats: Assessing the Promise of AI in Oncology, Toufic A. Kachaamy, MD, and Douglas Flora, MD, LSSBB, FACCC, discuss potential opportunities to leverage artificial intelligence tools in cancer screening, diagnosis, staging, and prognosis.
Christopher M. Gallagher, MD