Dr Lawrence Shulman Outlines the Potential of Value-Based Care in Oncology

November 1, 2019

Lawrence N. Shulman, MD, director of the Center for Global Cancer Medicine at the Abramson Cancer Center, and professor of Medicine at the Hospital of the University of Pennsylvania, discusses how value-based care can advance the quality of oncology care that it isn't currently.

Lawrence N. Shulman, MD, director of the Center for Global Cancer Medicine at the Abramson Cancer Center, and professor of Medicine at the Hospital of the University of Pennsylvania, discusses how value-based care can advance the quality of oncology care that it isn't currently.

Transcript

In what ways can value-based care advance the quality of oncology care that it isn't currently?

I think that value-based care can start to make us concentrate on what’s best for the patients but what’s also reasonable, and in the US, we sometimes have this mindset that more is better and sometimes in medicine, more is not better. We have to make the best decisions. In value-based care, or any other payment model, we still want to give our patients the best chance to do well. But we also need to take out of care what is not beneficial and in fact sometimes is harmful to patients.

We know there has probably been more chemotherapy given in the last 2 weeks of life than we should do that don’t really benefit patients and in fact may hurt them. We know that we don’t use hospice care at the end of life as much as we probably should. We know we probably do too many scans that really don’t change the way that we approach the patient and don’t improve their survival or their overall quality of life. I think we just need to be more careful about that. Value-based care makes us think a little more about it, and shares responsibility, if you will, with us and how we make those decisions.