IVBM All Coverage

Michael Kolodziej, MD, vice president and chief innovation officer at ADVI Health, Inc., discusses the move to 2-sided risk in the Oncology Care Model (OCM).

With Oncology Care Model performance period 4 results out now, it’s a transformative point in the model in which practices that have not yet achieved a performance-based payment have to either enter 2-sided risk or leave the model. To dive into the most recent results and their implications, we spoke with Charles Saunders, MD, chief executive officer of Integra Connect.

CMS is trying to make a 2-sided risk model in the Oncology Care Model enticing for practices, but there is still a lot of math practices need to work out before making the decision, said Blase Polite, MD, associate professor of medicine and the executive director for accountable care at the University of Chicago.

Lani M. Alison, BSN, MS, HCQ, PCMH, CCE, vice president of Clinical Affairs, Regional Cancer Care Associates, explains how the implementation of the Oncology Care Model (OCM) allowed practices to better integrate palliative care.

To date, most alternative payment models (APMs) that have emerged in the shift toward value-based care have been initiated by payers and focused on primary care providers. However, there has recently been a new wave of payment reform in which providers, mostly specialists, are designing and implementing their own APMs in their practices. A study published in the September issue of The American Journal of Managed Care® analyzed some of these new payment models to gain insight into what providers are prioritizing in their APMs.

Innovation that transform cancer care delivery have to be multi-level, explained Iuliana Shapira, MD, chief medical officer, Regional Cancer Care Associates.

Lani M. Alison, BSN, MS, HCQ, PCMH, CCE, vice president of Clinical Affairs, Regional Cancer Care Associates, explains the questions that patients have about oncology care pathways and treatment guidelines.

Coverage from the July 11, 2019, meeting of the Institute for Value-Based Medicine®, an initiative of The American Journal of Managed Care®. The meeting took place in Arlington, Virginia.

Iuliana Shapira, MD, chief medical officer, Regional Cancer Care Associates (RCCA), discusses how RCCA is managing the higher costs of immuno-oncology drugs in value-based care.

Lani M. Alison, BSN, MS, HCQ, PCMH, CCE, vice president of Clinical Affairs, Regional Cancer Care Associates, discusses how providers discuss the Oncology Care Model (OCM) with patients and the questions they ask about it.

The Institute for Value-Based Medicine®, an initiative of The American Journal of Managed Care®, traveled to Teaneck, New Jersey, for presentations in partnership with Regional Cancer Care Associates.

Value-based programs such as accountable care organizations appear to encourage the adoption and spread of care coordination activities by hospitals.

On this episode of Managed Care Cast, we’re bringing you a portion of a panel discussion about the Oncology Care Model, held in July 2019 during a meeting of The Institute for Value-Based Medicine® (IVBM), an initiative of The American Journal of Managed Care®. At IVBM events, we gather thought leaders to share best practices across medicine, pharmacy, and management in regional locations around the country. This podcast is taken from our meeting focusing on Innovation and Quality in Oncology Care.

Transitioning to value-based care is a marathon, not a race, and should be viewed as a mission and a culture, Jeff Hunnicutt, chief executive officer at Highlands Oncology Group, told Amy Ellis, director of quality and value-based care at Northwest Medical Specialties. In order to successfully transform a practice, there needs to be a clear message and set values ingrained in the mindset of staff at the frontline of patient care.

Iuliana Shapira, MD, chief medical officer, Regional Cancer Care Associates (RCCA), discusses how data analytics have improved RCCA’s revenue cycle.

Innovation is being used to improve quality metrics in oncology care at the patient forefront and in data, explained Lani M. Alison, BSN, MS, HCQ, PCMH, CCE, vice president of Clinical Affairs, Regional Cancer Care Associates.

Jason Mitchell, MD, chief medical and clinical transformation officer, Presbyterian Healthcare Services, discusses the role primary care will play in the transition to value-based care.

The University of Michigan Center for Value-Based Insurance Design (V-BID), in collaboration with a group of healthcare stakeholders, has announced the details of V-BID X, a template for reducing cost sharing for certain high-value services and raising cost sharing for certain low-value services while not increasing premiums or deductibles.

A new report from the HHS’ Office of the Inspector General praises 20 high-performing accountable care organizations (ACOs) for the strategies they are using in the shift to value-based care.

As value-based models continue to change the payment landscape in healthcare, the models require more sophisticated data, analytics, and payment structures, which can lead to more administrative burden, as well as siloed data.

Jason Mitchell, MD, chief medical and clinical transformation officer, Presbyterian Healthcare Services, discusses the role of commercial payers in the shift toward value-based care.

CMS has proposed the mandatory Radiation Oncology Model, which would cover radiation therapy spanning a 90-day episode.

Data is critical to all value-based care, said Jason Mitchell, MD, chief medical and clinical transformation officer, Presbyterian Healthcare Services.

In 2018, 33% of accountable care organizations (ACOs) assumed downside risk, up from 28% in 2012.

The Los Angeles gathering of the Institute for Value-Based Medicine focused on the need to intervene early in the course of diabetes, so that patients can avoid long-term complications. Over the past decade, cardiovascular outcomes trials for glucose-lowering therapies have revealed unexpected benefits, offering new opportunities for cardiologists.

Diabetes is a self-managed disease, which makes the role of diabetes education crucial in order for patients to succeed in managing their disease, said Kellie Rodriguez, RN, MSN, MBA, CDE, director, Global Diabetes Program, Parkland Health & Hospital System.

Coverage from The American Journal of Managed Care's® Institue for Value-Based Medicine® meetings.

A Quest Diagnostics webinar discussed how lab services fit in with value-based care strategies and could reduce total healthcare costs, improve care coordination, and enhance member experiences.

Diabetes educators can help patients with diabetes who face financial challenges make appropriate choices and receive assistance to afford medications, said Kellie Rodriguez, RN, MSN, MBA, CDE, director, Global Diabetes Program, Parkland Health & Hospital System.

The person-centered factors that drive outcomes in diabetes requires hospital systems that can actually address those needs, said Kellie Rodriguez, RN, MSN, MBA, CDE, director, Global Diabetes Program, Parkland Health & Hospital System.