The Lynx Group

Value-Based Care

Medicaid expansion under the Affordable Care Act was associated with significant increases in breast reconstruction surgery among non-Hispanic black women and women with lower income and education levels, according to results of a study presented during the American Society of Breast Surgeons 22nd Annual Meeting. At times, these increases achieved parity with non-Hispanic white women.
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The demands of value-based care have continued to evolve since oncologists began transitioning from fee-for-service to fee-for-value reimbursement more than five years ago. For community-based oncology practices, more change is coming with the introduction of the Oncology Care First Model, the successor of the current Oncology Care Model (OCM). Following a one-year delay caused by the pandemic, the Centers for Medicare & Medicaid Services is expected to launch the Oncology Care First Model in 2022 and will likely include a larger number of practices than the OCM.
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In recent years, the pace of innovation in healthcare has accelerated dramatically, ushering in new processes, therapies, technologies, and policies designed to increase efficiency, reduce waste, lower the cost of care, and improve clinical outcomes and quality of life for patients. However, along the way, stakeholders have encountered numerous obstacles that threaten to undermine the full potential of these advances. One of the most significant challenges is the fact that the development of innovation is frequently siloed, occurring within a specific subsector of the healthcare delivery ecosystem, with little consideration of the impact to other parts of the overall system.
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Cellular immunotherapy was featured prominently during ASH 2020, with many presentations detailing deep and durable responses in a range of hematologic malignancies, mostly large B-cell lymphoma.
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The use of a screening method followed by a financial toxicity intervention that involves navigators, pharmacists, and financial counselors demonstrated significantly improved quality of life for patients with hematologic malignancies, said lead investigator Thomas Greg Knight, MD, Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, at ASH 2020.
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The Future of Cancer Care Delivery
The future of cancer care delivery is shifting from fee-for-service to a value-based care approach.
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Protecting patients with cancer from financial hardship could save more than money. According to data presented at the 2020 ASCO Quality Care Symposium, mitigating the financial burden of cancer treatment on patients could save lives as well.
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Value-based drug purchasing, better coordination of care delivery, and earlier institution of palliative care were among the measures to lower the cost of cancer care that were suggested during a panel discussion at the 2020 virtual National Comprehensive Cancer Network (NCCN) Oncology Policy Summit. The discussion was moderated by Clifford Goodman, PhD, Senior Vice President, Comparative Effectiveness Research, the Lewin Group.
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Value-based or alternative payment models have yet to deliver the cost-savings in oncology hoped for when these models were proposed, said experts at the September 2020 National Comprehensive Cancer Network Oncology Policy Summit during a panel discussion on best practices for value-based agreements.
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When ASCO President Howard A. Burris III, MD, FACP, FASCO, chose the theme for the 2020 annual meeting—“Unite and Conquer: Accelerating Progress Together”—early last year, he never imagined that it would take on new meaning just 12 months later.
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