Dr Basit Chaudhry: Evaluating the Adequacy of Novel Therapy Adjustment Under OCM

April 29, 2019

Basit Chaudhry, MD, PhD, founder of Tuple Health, explains why it's important to evaluate the adequacy of the novel therapy adjustment under the Oncology Care Model (OCM).

Basit Chaudhry, MD, PhD, founder of Tuple Health, explains why it's important to evaluate the adequacy of the novel therapy adjustment under the Oncology Care Model (OCM).

Transcript

Why is it important to evaluate the adequacy of the novel therapy adjustment under the OCM as more of these therapies continue to enter the market?

Oncology is CMMI’s [Center for Medicare and Medicaid Innovation’s] first foray into a large-scale subspecialty model. One of the things that makes oncology so unique is that it’s so dynamic. The nature of the therapy literally changes month by month, and this is a key reason why we’ve made so much progress in terms of improving outcomes for patients. At the same time, it really does create tensions on how to think about to build a payment model. For payment and looking at value, ideally, you’d something that’s relatively stable that, for instance, allows you to predict the price of an episode better. But, if you’re constantly changing the inputs that physicians and practices are utilizing, then that makes the rest of this difficult.

I think in principle, the novel therapy adjustment was an interesting idea in trying to balance these 2 things. How do you balance the notion of needing to go to value in a field that’s constantly changing? I think in terms of its implementation, there’s some tensions there that have been lacking. So, there’s still a lot of work to be done there. But I think the impetus behind it, I think, is how do you maintain, essentially, innovation and therapy while still being able to construct value and to be able to predict that and stabilize it is a very big challenge.