Payment reform efforts that don't engage patients are missing out on an opportunity for greater improvements, especially in cancer, where patients face substantial cost sharing.
Payment reform efforts that don’t engage patients are missing out on a beneficial opportunity, according to a Viewpoint published in JAMA Oncology.
S. Yousuf Zafar, MD, of Duke Cancer Institute; Blase N. Polite, MD, MPP, of the University of Chicago Medicine; and Mark McClellan, MD, of Duke-Margolis Center for Health Policy, argue in the piece that new payment models that focus on making patients active participants in their health could prove to be more successful in encouraging higher-value care.
So far, explained the authors, payment reform efforts looking to improve quality of care and reduce costs have focused on encouraging practitioners and healthcare organizations. However, they noted that patients with cancer, who are facing high cost sharing, would benefit from “opportunities to share in the benefits of high-value practice.”
The authors highlighted 2 main opportunities to engage and support patients that are currently being missed.
Zafar, Polite, and McClellan have a few suggestions, such as shifting measure reporting to focus on patient-centered quality measures. Another option is creating a payment for Medicare beneficiaries who align care with an advanced OCM practice—practices that achieve significant savings would share them with the beneficiaries.
They also recommend extending the Medicare Advantage Value-Based Insurance Design to cancer. The pilot, which allows insurers to offer lower co-payments for high-value services or drugs, is only available for a limited set of chronic conditions.
“Enabling patients with cancer to share in the same kinds of financial benefits as health care organizations provides powerful opportunities for this engagement,” the authors concluded.
Zafar SY, Polite BN, McClellan M. Engaging patients in value-based cancer care: a missed opportunity. [published online August 02, 2018]. JAMA Oncol. doi:10.1001/jamaoncol.2018.2826.