In The News

Value-Based Care Is Changing Cancer Treatment Decisions as Drug Costs Continue to Rise

Community oncologists are caught between the movement to value-based care, with its aim to reduce costs while increasing quality, and the rising prices of innovative therapies that can be life saving for patients, according to a new survey from Integra Connect.

A value-based EHR

During the fee-for-service era, EHRs rose to prominence as tools to automate documentation of patient encounters, then inform subsequent billing workflows. With the continued growth of value-based care, however, administrators are finding that their practices’ areas of focus are beginning to change dramatically. MGMA’s 2018 Regulatory Burden Survey not only captured the frustration felt as practices get their arms around MIPS and emerging alternative payment models (APMs) — cited by 88% as “very or extremely burdensome” — but also the increasing pains attributed to their EHRs, led by a lack of interoperability (80%) and need to accommodate new government-imposed requirements (77%).

Reviewing Current OCM Performance Data and the Road Ahead

Charles Saunders, MD, chief executive officer, Integra Connect, and Lucio N Gordan, MD, managing physician and president, Florida Cancer Specialists, discussed recurring challenges, new pressure points, and opportunities to close performance gaps after the midway point of OCM in a session at the Association of Community Cancer Centers (ACCC) Annual Meeting and Cancer Center Business Summit (March 20-22, 2019; Washington, DC).

Current State of Value-based Care in Oncology: 13 Key Trends to Know

New data on the state of value-based care in oncology has found that while community oncologists are optimistic about the beneficial potential of value-based care, they see a conflict between the need to decrease episode costs and the rising prices of the most innovative novel therapies.

Prescription Drug Costs Challenge Value-Based Care in Oncology

Approximately 57 percent of community oncologists in value-based care models identified prescription drug costs as their top challenge with alternative payment model success, a recent survey uncovered.

Learning to Manage Data and Code for Comorbidities Is Critical for OCM Success

Data is of critical importance in the Oncology Care Model (OCM)—and CMS shares a lot of data with participating practices—but managing that data and using it to improve performance can be challenging, according to panelists at Patient-Centered Oncology Care^®.

RCM tip of the day: Model revenue streams to help predict cash flow

As specialty medical practices model and manage potential revenue under value-based healthcare, they should prepare for both positive and negative financial scenarios, cautioned Parag Shah, president of practice solutions at Integra Connect, a provider of technologies and services for value-based specialty care.

Tools urologists need to thrive in a value-based world

With 2018 behind us, it is a natural time to reflect on the major developments that took place in health care in general and urology specifically. For many, it will be remembered as the year that value-based care became a reality.

Running the Numbers

This article discusses the advantages of leveraging advanced analytics in value-based oncology care.

Four Ways RCM Must Transform for the Shift to Value-Based RCM

It is likely that 2018 will be remembered as the year that value-based care became a financial reality for most U.S. medical practices. Those participating in MIPS (the Merit-based Incentive Payment System) received their first round of results and a view of the impact on future reimbursement rates.

Specialists taking part in advanced alternative payment models (APMs) such as the Oncology Care Model (OCM) program were also provided performance reports from CMS, in some cases accompanied by unexpected claw back demands. Finally, commercial payers such as UnitedHealthcare and Aetna promoted research and forecasts attesting to the increasing influence of value-based contracts in the reimbursement mix.