Innovative Payment Models in Oncology - Episode 1

Stakeholder Voice in Developing Oncology Payment Models

In this opening segment of this one-on-one interview series, a part of the Oncology Stakeholders Summit, Spring 2015, Michael Kolodziej, MD, and Ted Okon, MBA, discuss which stakeholders’ opinions matter most in the development of improved oncology payment models.

Mr Okon, executive director of the Community Oncology Alliance, says that the most crucial voice during the development of a payment program is the patient’s. Additionally, he discusses why insight from providers (ie, individual practitioners, group practices, and hospitals), nurses, private payers, pharmaceutical companies, and medical device manufacturers is important.

It is important to consider the opinions of payers, providers, and patients, remarks Dr Kolodziej, a national medical director of oncology strategy for Aetna. He adds that in order for a payment model to be successful, there needs to be “harmonization” among these stakeholders.

Mr Okon also discusses the progress of the State Innovation Models initiative by the Center for Medicare & Medicaid Innovation, and shares his concerns about the program’s potential in oncology. Although substantial monetary investments have been made in these programs, Mr Okon notes that not much information is available on how these programs are doing. Mr Okon explains that he feels a lot of innovation may be possible at the state level, and he would like to see more transparency and more accountability in the near future.

Watch our related Peer Exchange, Oncology Stakeholders Summit, Spring 2015