Innovative Payment Models in Oncology - Episode 2
Ted Okon, MBA, expresses concern that as state healthcare innovation plans develop, there may be a lack of collaboration among states in the sharing of data. To be successful, data exchange is vital, he says.
On the topic of quality measures, Mr Okon adds that without collaboration among states, different states will have different quality measures. He advises that whether implemented at a state level or at the federal level, the same measures must be used. The quality measures that have been established following the development of new payments models under the Affordable Care Act do not have much bearing with regard to oncology care, comment both Michael Kolodziej, MD, and Mr Okon.
Mr Okon explains that several variations of the Accountable Care Organization (ACO) model have been established. Although these models are a “head start” in leading innovation, he suggests that there are fundamental problems that need to be addressed. Specifically, the quality measures established for Medicare ACOs launched by Medicare do not pertain to routine cancer care, notes Mr Okon, and that instead of allowing the federal government to dictate quality measures, input from providers and patients is necessary when addressing these challenges.
Aetna is partnering with several provider systems with regard to ACO models, Dr Kolodziej remarks. He explains that Medicare’s projections for the number of patients they would like to enroll in alternative payment programs are aggressive, and adds that Aetna is working in parallel with Medicare and the new ACO payment models.
Watch our related Peer Exchange, Oncology Stakeholders Summit, Spring 2015