Aligned with ASCO's Patient-Centered Oncology Payment model, Anthem has launched its value-based strategy called the oncology medical home, which seeks to promote quality metrics and improve outcome measures in cancer care.
Aligned with the American Society of Clinical Oncology (ASCO)'s Patient-Centered Oncology Payment model, Anthem has launched its value-based strategy, called the oncology medical home, which seeks to promote quality metrics and improve outcome measures in cancer care, said David Debono, MD, medical director of Oncology at Anthem.
Transcript
AJMC®: How has the use of value-based models evolved in cancer care?
Dr Debono: Anthem has recently launched the value-based strategy that we're calling the oncology medical home. The oncology medical home is aligned with ASCO’s Patient-Centered Oncology Payment model. ASCO has gone to great lengths to really provide a guideline for payers and oncology practices on how best to execute value-based strategies.
Their Patient Centered Oncology Payment model centers on 4 components. The first component is what they call practice delivery requirements and we have called our core competencies. These are the type of care processes and comprehensive care that must be available to our members who are receiving oncology care, either within an oncology practice or a cancer center.
The second component of ASCO’s program is participation in a pathways program. We believe that our pathways program, again, is encouraging value-based strategies in oncology and ensuring high-quality care for our members.
The last 2 parts of ASCO’s model revolve around financial incentives for oncology practices. The first is a monthly care coordination fee, and Anthem has designed their monthly care coordination fee to be attributed to those members who are on outpatient chemotherapy or immunotherapy. We believe that the monthly care coordination fee will help support the practice, as they transform their care from a fee-for-service environment to a value-based environment.
The final component of ASCO’s model includes financial incentives for quality care and quality metrics. We have designed financial incentives to be associated with practices improving on quality metrics and improving on outcome measures. We believe that encouraging the improvement of these quality metrics will move the oncology practice toward a higher-value care, without compromising on the exciting modern therapies of precision medicine in oncology.
ATS 2024: Bridging the Past, Present, and Future of Respiratory Care
May 16th 2024The application of artificial intelligence in medicine is anticipated as a highlight of ATS 2024, with sessions exploring its applications in research, radiological interpretation, and pediatric pulmonology.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
Health Equity and Access Weekly Roundup: May 11, 2024
May 11th 2024This week's topics include frameworks for improving health equity nationwide, addressing social determinants of health, discussing CMS's Medicare rules, investigating breast cancer treatment refusal, and exploring HIV and major depressive disorder in underrepresented groups.
Read More
Reaching Rural America: Value-Based Care Solutions for Systemic Health and Social Inequalities
March 7th 2023On this episode of Managed Care Cast, we speak with Jennifer Schneider, MD, co-founder and chief executive officer of Homeward, a value-based care provider aiming to improve access to high-quality care in rural communities through tech-enabled clinical services, partnerships with local physicians and health plans, and community-level demographic data.
Listen
Posters Characterize DMD Caregiver Experiences, Impact of Gene Therapy on Caregiving Demands
May 10th 2024Posters presented at the ISPOR—The Professional Society for Health Economics and Outcomes Research meeting explored Duchenne muscular dystrophy (DMD) caregiver experiences and gene therapy’s impact on work opportunities for caregivers.
Read More