The Lynx Group
Association for Value-Based Care

Value-Based Contracting for Cancer Care

Conference Correspondent

Michael Kolodziej, MD, Senior Advisor at ADVI Health, started off the November 19 session of the Association for Value-Based Cancer Care (AVBCC) 10th Annual Summit by posing the question: What outcomes should we expect given the money we spend?

Depending on the stakeholder, value-based contracting can have several definitions and meanings, which makes designing and implementing the solutions more complex.

From a payer perspective, John Fox, MD, Former Associate Vice President of Medical Affairs at Priority Health, expressed concern for risk in value-based contracts. Payers take on all the risk for the cost of a therapy, regardless of whether the therapy performs.

Erin Smith, JD, Director II of Payment Innovation at Anthem, believes that value-based contracts should ensure that the healthcare we receive is valuable and affordable, although there is much that still needs to be done to improve and automate measurement of value and outcomes.

Brian Ragan, PharmD, BCPS, Value-Based Contracting Executive at Humana, said that in a perfect world, value-based contracts would have consistent, standardized, meaningful measures, and we should currently be looking at overall survival or total cost of care.

Regarding the Oncology Care Model (OCM), Brian Bourbeau, MBA, Division Director of Practice Health Initiatives at the American Society of Clinical Oncology, said that his experience with OCM was positive, and that the money was invested into processes and data teams that improved care.

Bhuvana Sagar, MD, National Medical Executive at Cigna Health Care, said that provider-built pathways could work with checks and balances. Dr Sagar believes we do not currently have comprehensive pathways, and the ones that do work are smaller with localized data. Payer pathways are drug-based out of necessity, and physicians may be using pathways that do not have evidence for the best possible outcomes for patients.

Gain access to these in-depth, expert views on the future of value-based analytics in oncology practices when you register for the AVBCC Summit!

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