With so many different oncology alternative payment models (APMs) available, choosing the right ones to participate in might simply mean finding which ones already align with what a practice is doing, said Amy Ellis, chief quality officer at Northwest Medical Specialties.
With so many different oncology alternative payment models (APMs) available, choosing the right ones to participate in might simply mean finding which ones already align with what a practice is doing, said Amy Ellis, chief quality officer at Northwest Medical Specialties.
Transcript
Recently, the Community Oncology Alliance released a report that there are more than 30 oncology-related APMs. How does Northwest Medical Specialties determine which model to participate in?
There's a lot of different APMs out there. And what we really try to do is look at the quality measures that that specific APM is requiring, or that specific payer, and how it aligns with our current programs. We don't want to get into a situation where we have 15 different programs with 15 different quality measure rules and methodologies, because there is a lot of administrative burden that takes place behind the scenes of all of these APMs, whether that be, you know, billing out the MEOS [Monthly Enhanced Oncology Services], or tracking the patients—all of these different things.
So, what we really try to do is find out what's aligned with what we're already doing. And of course, there's some wiggle room. If there's something that's trying to introduce a new measure for us, or maybe has a slightly different methodology, we're open to that. But when you get into a space where you have these completely different models, that means you may need more staff to support those models. I think those are the really the key things that we look at is really alignment between the models.
CMS' 340B Repayment Proposal May Harm Vulnerable Hospitals, Reward Those With Higher Revenues
April 26th 2024The 340B hospitals not receiving an offsetting lump-sum payment from CMS following 2018-2022 cuts later ruled unlawful are disproportionately rural, publicly owned, and nonacademic, according to a new study.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Dr Dalia Rotstein: Physicians Must Be Aware MS Affects People of All Backgrounds
April 24th 2024Dalia Rotstein, MD, MPH, emphazises the importance of awareness that multiple sclerosis (MS) impacts patients from various backgrounds as clinicians think through ways to improve access to care and research efforts in MS.
Read More
Empowering Community Health Through Wellness and Faith
April 23rd 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In the third episode, Camille Clarke-Smith, EdD, MS, CHES, CPT, discusses approaching community health holistically through spiritual and community engagement.
Listen
Beyond Insulin: The Impact of Next-Generation Diabetes Technology
April 17th 2024Experts explain how new diabetes technologies like continuous glucose monitors are transforming care beyond intensive insulin therapy, offering personalized insights and improving outcomes for patients of all treatment levels.
Read More