Evidence-Based Oncology Explores Benefits, Challenges of Alternate Payment Models in Cancer Care

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As MACRA pushes physicians toward value-based reimbursement, how can the needs of cancer patients be served? The current issue of Evidence-Based Oncology,ââ€


CRANBURY, N.J.—The revolution in how physicians will be paid brings unique challenges to cancer care, where individual patient needs may make costs hard to predict. As oncologists and payers adapt to this new environment, Evidence-Based Oncology™, (EBO™)a publication of The American Journal of Managed Care®, has published a special issue on the benefits and challenges of alternate payment models (APMs), which are encouraged under the Medicare Access and CHIP Reauthorization Act (MACRA).

The traditional definition of value—costs over outcomes—cannot always incorporate the clinical and diagnostic risks that oncologists take in deciding how to proceed, writes Joseph Alvarnas, MD, director of Value-Based Analytics at City of Hope and editor-in-chief of EBO™.

“Value has become a catchword in healthcare,” Alvarnas writes. “This has been true for a while already within the domain of cancer care, where the extraordinary complexity and intensity of effective care, coupled with the astronomical prices of new anticancer agents, have led many to question the economic sustainability of delivering effective and innovative care to this population of patients.”

In this special issue:


· Authors from Deloitte say financial incentives cannot be the only factor driving adoption of APMs. They compare the benefits of new approaches, including CMS’ Oncology Care Model.

· Authors from the American Society of Clinical Oncology (ASCO) and practicing oncologists discuss ASCO’s Patient-Centered Oncology Payment model, which they say addresses both the Triple Aim—increased patient satisfaction, improved outcomes, and lower costs—and a fourth element: improving life for providers.

· Jeffrey W. Chell, CEO of the National Marrow Donor Program, writes that Medicare must standardize reimbursement policies so that providers do not lose money for transplants to treat blood disorders.

· Authors from Flatiron Health discuss the day-to-day problems of making APMs work, and how technology is essential to overcome them.

About The American Journal of Managed Care®:

The American Journal of Managed Care® (AJMC®) is a peer-reviewed, MEDLINE-indexed journal that keeps readers on the forefront of health policy by publishing research relevant to industry decision makers as they work to promote the efficient delivery of high-quality care. is the essential website for managed care professionals, distributing industry updates daily to leading stakeholders. Other titles in the AJMC® family include The American Journal of Accountable Care® and two evidence-based series, Evidence-Based Oncology™ and Evidence-Based Diabetes Management™. These comprehensive offerings bring together stakeholder views from payers, providers, policymakers and other industry leaders in managed care. To order reprints of articles appearing in AJMC® publications, please contact Dr. Jeff Prescott at (609) 716-7777, x331.


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