What are some of the challenges that clinical practices will face as they implement the Medicare Oncology Care Model (OCM)? What are some of the strategies that have worked for practices using similar payment models? These were some of the questions discussed at the Payer Exchange Summit V.
At the Payer Exchange Summit V, sponsored by the Community Oncology Alliance, held October 24-25, 2016, in Tyson’s Corner, Virginia, Bruce Gould, MD, presented an overview of how cancer care has improved over the years, what the challenges are, and how practices can adapt to payment reform.
Employers face tough decisions about rising costs, high-quality care, coordination of benefits, and workplace accommodations when employees are diagnosed with cancer, but they will always want to support those employees as best they can, according to Marianne Fazen, PhD, president and CEO of the Texas Business Group on Health.
Adopting the Oncology Care Model (OCM) is a challenging task for oncology practices that have to redesign their practices, but the shift from volume-based to value-based care is the way of the future, said Kashyap Patel, MD, of the Carolina Blood & Cancer Center.
Including a real-time decision support tool in the prior authorization process significantly reduced the cost of therapy for UnitedHealthcare, while complying with nationally accepted guidelines established by the National Comprehensive Cancer Network.


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Vienna, Austria
June 17-20, 2015
Lugano, Switzerland
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