Presentation 1: Oncology Practice in the Era of PCMHs and ACOs: Square Pegs or Round Holes?

Dr Peter Bach says professionals are looking at opportunities for new payment models and care redesign, but there are also threats that might surface. Each type of insurance payment model has different levels of risk factors. New payment models, such as the UHC pathways program and CMMI demo, have limited risk.

In regard to the future of payment, Dr Bach suggests that models such as the patient-centered medical home and accountable care organization, which boast shared savings, are likely to be useful. For oncology, the general “thrust” is to find savings outside drug expenditures, including reduced use of testing and avoiding hospitalization costs. “The general trend is to move risk, and it’s to move it where the discretionary decisions are made,” says Dr Bach. “It’s not a question of if, but when.”

Dr Bach also elaborates on why the site of care matters. Programs such as 340B, which offers discount drugs to hospitals that treat large populations of poor patients, impact costs. Finally, Bach suggests how this shift in site of care could benefit oncology patients.