August 2015 Vol 8, Special Issue: Payers' Perspectives in Oncology

At the special session on value during ASCO 2015, Jennifer Malin, MD, PhD, presented the payer perspective on value in cancer care
Recent breakthroughs in cancer treatments have come with an enormous price, forcing patients to make difficult trade-offs between very high out-of-pocket costs and expensive treatment, with measurable but often modest health benefits.
According to one breast cancer advocate, when patients are asked to define “value” in the context of their cancer treatment, cost is not the first thing that comes to mind.
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.
Endocrine therapies are the basis of treatment for patients with hormone-receptor (HR)-positive breast cancers, but many women experience disease relapse during or after completing adjuvant therapy.
With better understanding of the biological underpinnings of cancer, precision medicine has evolved beyond a mere concept to an actual, real-world pursuit.
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Results 21 - 30 of 37
  •  Association for Value-Based Cancer Care
  • Oncology Practice Management
  • Value-Based Cancer Care
  • Value-Based Care in Rheumatology
  • Rheumatology Practice Management
  • Urology Practice Management
  • Lynx CME