Dr David Debono Details Anthem's Value-Based Strategy in Cancer Care

September 25, 2020

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.