Value-Based Care Tackles Oncology Costs

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Oncology spending has grown unabated for years, with systemic cancer costs forecast to grow by as much as 40% from 2010 to 2020, reaching $173 billion, according to Community Oncology Alliance (COA). While this growth can be attributed to improved longevity, earlier detection and changes in care settings—such as the increased use of hospital settings for patient care in lieu of less-expensive, community-based settings—novel therapies continue to remain a primary cost driver.

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Mind the gap: Precision medicine shortcomings in NSCLC

Healio - HemOnc Today

This year’s ASCO Annual Meeting included several major successes that should translate to new molecular targets in advanced non-small cell lung cancer, but recent real-world evidence should lead us to take a hard look in the mirror and realize we’re failing to deliver on the promise of the treatments we already have.

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Lessons from the front lines of value-based care: The OCM’s impact on community oncology

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Nearly three years after its introduction, the CMS’s Oncology Care Model (OCM) remains the most ambitious and far-reaching initiative to shift cancer care toward value-based models.

The impact on community oncology, where almost 55% of U.S. cancer patients receive treatment1, has been especially pronounced. Our experiences supporting the success of one of the largest OCM cohorts—approximately 900 providers and 25,000 patients—has enabled us to aggregate their experiences into a snapshot of the program’s positive impacts, its challenges, and the broader implications for providers, pharma, and payers.

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Examining the Impact of a Palliative Care Program at a Large OCM Community Practice

journal of clinical pathways - Implementing Technology in Community-Based Practice Offers Multiple Advantages

At the American Society of Clinical Oncology (ASCO) Annual Meeting (May 31 – June 4, 2019; Chicago, IL), Journal of Clinical Pathways spoke with Adil Akhtar, MD, Michigan Health Professionals, and Charles Saunders, MD, Integra Connect, regarding the cost implications and quality improvement opportunity of a palliative care program at a large Oncology Care Model (OCM) community practice, along with the “cultural change” surrounding palliative care in oncology.

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On the Horizon for Value-Based Oncology Care: Predictive Analytics, Novel Therapy Pricing Pressures, New Payment Models, and a Rise in Complex Data Sources

journal of clinical pathways - Implementing Technology in Community-Based Practice Offers Multiple Advantages

January 2019 represented another major inflection point for the Oncology Care Model (OCM), marking the halfway point of the 5-year program. Overall, while OCM participants have expressed concerns about perceived flaws in the program, from attribution logic to novel therapy adjustment, the cohort of OCM participants who work with Integra Connect all agree that value-based cancer care is inevitable and are motivated to help drive its success­—both under the OCM and in the long-term as more commercial payers adopt value-based models.

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What are the latest results from Medicare’s Oncology Care Model?

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The Oncology Care Model (OCM) was launched in July 2016 to further delivery of higher quality, more coordinated cancer care at a lower cost to Medicaid. In return for delivering enhanced services such as care management and coordination, and generate sustainable cost savings, OCM participants, representing nearly one-third of community-based oncology practices across the US, would receive a payment of $160 per beneficiary per month for the duration of a qualifying 6-month chemotherapy period, plus the opportunity to earn a share of savings if they exceed a target price threshold.

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