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Aaron Lyss: Nuances of Oncology Make Creating Value-Based Payment Models a Challenge

While the healthcare industry moves more toward value-based payment models, oncology practices are at a disadvantage because few payers truly understand the nuances of cancer care to design good oncology payment models, explained Aaron Lyss, director of value-based care for Tennessee Oncology.


While the healthcare industry moves more toward value-based payment models, oncology practices are at a disadvantage because few payers truly understand the nuances of cancer care to design good oncology payment models, explained Aaron Lyss, director of value-based care for Tennessee Oncology.

Transcript

How can practices navigate still being in fee-for-service while partially moving to value-based care models?

I think that one of the challenges that community oncology practices face as they participate in value-based payment models is that not all payers have an equal understanding of the nuances of oncology in ways that are really important to designing these models. So, there are only a handful of payers in the commercial payer environment that really understand oncology well enough to design good oncology payment models. So, a lot of what they have to rely on are, “what are the outcomes of the Medicare models?” Which have their own problems and their own challenges.

So, I think that’s sort of what I would call the major challenge that we see broadly in the managed care market in participation in these programs is simply that the nuances of cancer care are such that it’s hard to find, especially in the medical leadership in the payer space, folks who really understand how to design good oncology payment models.

 
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