An alternative to the “buy-and-bill” system for outpatient chemotherapy is inevitable as average sales price (ASP)-based chemotherapy payment is being challenged by payers and by policymakers, said a panel of speakers at ASCO 2015 who critically assessed this method of reimbursement for chemotherapy drugs.
Payment reform that is centered around the patient by aligning payments to oncology practices for all services performed is a “win-win-win” approach for physicians, patients, and payers
Payment models that align reimbursement to support treatment planning and care coordination encourage oncology care providers to adhere to cancer treatment pathways.
UnitedHealthcare is determining the best way to institute payment bundling, according to Lee N. Newcomer, MD, MHA, UnitedHealth Group’s Senior Vice President of Oncology, Genetics and Women’s Health, who described the payer’s pilot project conducted at M.D. Anderson Cancer Center at ASCO 2015.
A transition from reimbursement based on volume to reimbursement based on value has begun to emerge, said speakers at ASCO 2015 in a session on payment reform.
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