August 2016 Vol 9, Special Issue: Payers' Perspectives in Oncology - Online First, Value in Oncology
Wayne Kuznar

The ASCO 2016 meeting attracted 37,500 attendees from more than 125 nations around the world, and featured more than 5800 abstracts.

In her presidential address, Julie M. Vose, MD, MBA, Chief of the Oncology/Hematology Division, University of Nebraska Medical Center, Omaha, highlighted the importance of multimodal care and its effect on the quality of care and enhancement of clinical trial participation among patients with cancer.

The theme of this year’s conference was “Collective Wisdom: The Future of Patient-Centered Care and Research.” Incorporating new areas of expertise into cancer care will transform how cancer care is delivered, said Dr Vose.

In the next few decades, a “tsunami” of patients with cancer is expected as a result of the aging US population, she said. Caring for this influx of patients with an oncology workforce that will not grow quickly enough to meet the demand for services will be a challenge; in that sense, multidisciplinary care is a must to deliver quality care.

“Quality care will increasingly be understood to include advanced practice providers and other patient care specialists to meet patients’ evolving care needs. The second part of my theme—‘patient-centered care and research’—signifies the importance of this need. By concentrating our efforts around the patient’s needs for cancer treatment, supportive care, as well as survivorship care, we will be able to learn from every patient today in order to help the cancer patients of tomorrow. That is the value of collective wisdom,” said Dr Vose.

Finding new efficiencies in a clinical trial methodology is another one of ASCO’s tasks. “We believe there is room for streamlining the clinical trials process to increase the number of patients on clinical trials, decrease the cost of trials, and accelerate the time to completion. We need our clinical trials process to be a lean, mean, cancer-fighting machine,” Dr Vose said.

Despite more than 1.6 million cancer diagnoses expected in the coming year in the United States, only 3% of adult patients with cancer will enroll in clinical trials.

Responding to Changing Reimbursement

Dr Vose also noted the inevitable change in the reimbursement for oncology services, with an emphasis on value. ASCO, along with other stakeholders, has worked to have Medicare’s sustainable growth rate (SGR) for physician reimbursement repealed.

“We were pleased and optimistic when SGR was finally repealed last year. However, we must now educate ourselves on the new initiative: the Medicare Access and CHIP Reauthorization Act [MACRA],” Dr Vose said.

MACRA is intended to move toward Medicare’s goal of paying for high-value care. It enables healthcare providers to take part in 1 of 2 quality programs—the Merit-Based Incentive Payment System (MIPS) or an alternative payment model.

MIPS will go into effect in 2019, but 2017 will be the baseline for measuring and scoring physician performance. MIPS will streamline existing performance reporting programs, including the Physician Quality Reporting System, Meaningful Use, and the Value-Based Modifier, into a new performance measurement program with 1 score for all components.

Recognizing the shift from fee-for-service medicine to quality- and outcomes-based medicine, ASCO assembled a large task force that developed the Patient-Centered Oncology Payment (PCOP) model.

“The ASCO PCOP model decreases avoidable costs, such as hospitalizations, emergency room visits, and excessive treatments and tests, while shifting and enhancing the support of needed services, such as case management and coordination. Our treatments are only as good as our ability to deliver them to patients, so it is imperative that we respond nimbly and effectively to today’s changing healthcare system,” Dr Vose said.

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Last modified: October 3, 2016
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