Value-Based Care

San Diego, CA—The American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) developed frameworks to determine the relative value of novel therapeutic agents. These value frameworks, however, may need to be modified to assess treatments for hematologic malignancies, suggested Matthew C. Cheung, MD, SM, FRCPC, Clinical Hematologist, Odette Cancer Centre, Toronto, Ontario, Canada, at the 2016 American Society of Hematology meeting.

San Diego, CA—New research from Canada supports the use of frontline therapy with bendamustine plus rituximab for patients with indolent B-cell non-Hodgkin lymphoma (NHL), reported Andrew Aw, MD, MEng, FRCPC, Division of Hematology, Ottawa Hospital, Ontario, Canada, at the 2016 American Society of Hematology meeting.

San Diego, CA—A study examining the feasibility and applicability of the American Society of Clinical Oncology (ASCO) Value Framework in chronic lymphocytic leukemia (CLL) suggests that the tool, although useful in assessing a small percentage of drug regimens, may need to be amended to be useful in CLL, reported Erlene K. Seymour, MD, Assistant Professor, Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, at the 2016 American Society of Hematology meeting.

“Value” in healthcare has been defined as outcomes relative to cost. Determining the value of a healthcare benefit remains difficult and complex for many stakeholders. With the increasing cost of cancer therapies, value has become an important topic of conversation for patients, healthcare providers, self-funded plan sponsors (employers), and payers.

A new payment and delivery model introduced by the Center for Medicare & Medicaid Innovation aims to align financial incentives to improve oncology care and outcomes. Expected to begin in July 2016, the program will target patients from the start of their chemotherapy through 6 months of care.

Society meetings, such as the recent American Society of Hematology (ASH) annual meeting, generate a lot of clinical-related excitement regarding new treatment options, protocols, and pathways for hematologic cancers.

Medicare has initiated several programs in the past decade to encourage value, but questions remain regarding their effectiveness. At ASH 2015, Andrew Ryan, PhD, MA, Associate Professor of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, addressed the implications of using financial incentives to drive care quality and reduce cost.

Washington, DC-An evolving knowledge of cancer biology and the availability of comprehensive genetic testing engender a need for tools that help oncologists integrate these data and select therapy, said Gary Palmer, MD, Chief Medical Officer, NantHealth, Los Angeles, CA, in delivering his keynote address at the Fifth Annual Conference of the Association for Value-Based Cancer Care.

At the Fifth Annual Conference of the Association for Value-Based Cancer Care in Washington, DC, Grant Lawless, RPh, MD, FACP, of the University of Southern California, Los Angeles, moderated a multidisciplinary panel on value-based care for patients with multiple myeloma.

“Centers of Excellence” (COEs) is not a new concept in healthcare. The underlying hypothesis is that providers who specialize in a particular procedure or service will produce superior, predictable outcomes. Payers have developed COE networks to manage cost and quality for complex medical conditions for more than 2 decades, steering volume to high-performing providers in exchange for discounted contractual rates. Under significant pressure to reduce the burden of cancer spending, payers are beginning to make bold network decisions, including narrowing networks, but they need precision tools to ensure that quality of care is uncompromised, and even improved, while reining in unsustainable cost trends.