New Payment Model to Transform Cancer Care Delivery, Patient Care

The American Society of Clinical Oncology (ASCO) recently released an update to its Patient-Centered Oncology Payment (PCOP) model, which now reflects lessons learned from previous demonstration programs, and will be improving the quality and delivery of cancer care.

The

is an alternative payment model designed to support transformation in cancer care delivery and reimbursement while ensuring patients with cancer have access to high-quality, high-value care.

ASCO's oncology-specific model is used to confront care delivery challenges in an increasingly complex medical specialty. It addresses an array of pressures facing cancer care, including the growing financial burden on patients and families and increasing administrative burdens on practices as a result of expanding utilization management requirements, according to a release.

There is currently a PCOP pilot in New Mexico.  

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The PCOP update comes after more than five years of work by ASCO volunteer groups, including leading medical oncologists from diverse practice settings, seasoned practice administrators, payer representatives, and experts in physician payment and business analysis.

"As oncologists, we have a responsibility to shape the future of America's cancer care system," says Howard A. "Skip" Burris, III, MD, FACP, FASCO., president of ASCO. "We're stewards of our patients' wellbeing, and ASCO's model reflects everything we have learned in over fifty years of work to advance patient care. It is a complete solution for transforming cancer care delivery and reimbursement and puts the needs of patients front and center."

The ASCO model transforms cancer care using three major approaches: improved care delivery and coordination through an oncology medical home framework, which has shown improved outcomes and reduced costs; a performance based reimbursement system that relies on patient-centered standards and transitions to bundled payments; and consistent delivery of high-quality care using clinical pathways that adhere to ASCO criteria.

ASCO’s focus is to implement this update into communities such as multidisciplinary networks of oncology providers and practices; federal, state, and private payers; employers; and regional health networks, in order to better support a patient-centered care, the release says.

This focus provides the following benefits:

• For patients, it offers access to an enhanced patient experience and state-of-the-art cancer care.

• For providers, it enables a successful transition to value-based systems.

• For employers and health plans, it offers a powerful way to encourage quality and limit costs.

ASCO has projected potential for PCOP to yield cost savings by 8% across the healthcare system, based on data from the Main Health Data Organization.

The model accommodates diverse practices and care settings and is designed to guide participants through the implementation process, the release says.