Value-Based Care

The American Society of Clinical Oncology (ASCO) recently released a major update to its Patient-Centered Oncology Payment (PCOP) model, an alternative payment model designed to enable all oncology practices to deliver higher-­quality care at lower cost. The update comes more than 5 years after ASCO released its first model and incorporates feedback from medical oncologists in diverse practice settings, as well as practice administrators, payer representatives, and experts in physician payment and business analysis.

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There is a growing recognition among payers and providers that social determinants of health—the social and socioeconomic factors that influence a patient’s care, such as income and access to transportation—are strongly linked to health outcomes. This recognition has been reinforced by a shift toward value-based payments, which incentivizes improved health outcomes rather than service delivery alone. Although it is evident that mitigating adverse social determinants can have a positive impact on patient outcomes and curb spending, results from a recent study reveal that Accountable Care Organizations (ACOs) face substantial challenges in integrating social services with patient care (Murray GF, et al. Health Aff (Millwood). 2020;39:199-206).

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Chimeric antigen receptor (CAR) T-cell therapy is now approved as third-line treatment for patients with B-cell lymphomas and leukemias. For some patients, CAR T-cell therapy is a miracle therapy, extending survival and, in some cases, as a bridge to a potentially curative transplant. But at an estimated cost of $375,000 to $475,000 per person, many people have questioned the value of this treatment, and whether it can be delivered effectively to patients not enrolled in clinical trials. Read More ›

The impact of poverty and low socioeconomic status on health and survival among children may be even more debilitating than suspected, according to new data presented at ASH 2019. Even in clinical trials, which are designed to provide consistent treatment across groups, socioeconomic status was associated with “substantial” differences in survival, researchers were surprised to find out. Read More ›

Chicago, IL—Reduced-dose chemotherapy is as effective as full-dose chemotherapy for frail elderly patients with advanced gastroesophageal cancer, according to results of the phase 3 GO2 clinical trial presented at ASCO 2019. Lower doses of oxaliplatin plus capecitabine (OCap) led to similar survival outcomes and improved quality of life compared with higher doses of that regimen. Read More ›

Since July 2016, more than 170 oncology practices across the United States have been participating in the Oncology Care Model (OCM), the Center for Medicare & Medicaid Innovation (CMMI)’s 5-year pilot program designed to deliver higher quality, more coordinated oncology care at the same or lower cost. When practices elected to participate in the OCM, they knew they would eventually have to decide whether to accept 2-sided risk or leave the program, if a performance-based payment was not achieved. Read More ›

As the treatment landscape in oncology changes on a seemingly daily basis, providers face increasingly complex decisions, and it is not just the myriad of therapies available: oncologists must balance drug efficacy and toxicity, clinical outcomes, and patient quality of life, all while providing value-based care. Enter clinical pathways, a multidisciplinary management tool used to guide evidence-­based care for subgroups of patients with predictable clinical courses. Read More ›

Real-world data highlight the significant clinical and economic burden associated with venous thromboembolism (VTE) in patients with cancer. The data come from a study of 12,785 patients hospitalized with acute illnesses, of which 2002 patients had cancer. Read More ›

An analysis of real-world administrative claims data in patients with chronic lymphocytic leukemia (CLL) has highlighted the need for treatments that result in fewer adverse events, according to data presented at ASH 2018. Read More ›

The drug affordability rating in the National Comprehensive Cancer Network (NCCN) Evidence Blocks are inconsistent with real-world total episode of care costs, according to Scott D. Ramsey, MD, PhD, Director, Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA. Read More ›

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