Dr Joseph Alvarnas Discusses Clinical Risk in Value-Based Cancer Care

The new era of data informatics tools can help providers and payers understand the tiers of risk that determine the economics of care delivery, which is crucial to value-based cancer treatment, according to Joseph Alvarnas, MD, of the City of Hope and editor-in-chief of Evidence-Based Oncology.

Transcript (slightly modified)

Patients with more advanced disease could result in higher costs and worse outcomes. Do risk-based payment models account for this?

So you’re kind of talking to an area that I find fascinating. In my current role at the City of Hope I work as the director of value-based analytics, and part of that is trying to figure out the global cost of care, but I think the other part of it, which I think is the key to mastering economic sustainability, particularly at academic cancer centers, is understanding how clinical risk translates into the cost of care delivery.

I think when we engage payers on these issues of value, if we look simply at a blanket diagnosis then we do a disservice both to the payer and to ourselves. Our value proposition is predicated upon really understanding the cost structure of delivering care, and understanding the, I would say, deep-seated connections between someone’s genomics, someone’s proteomics, the nature of their cancer, their comorbidities, so that we can talk more meaningfully about this patient and their projected cost of care.

So I think ultimately what we have to look toward is as we can leverage this enormously powerful era of data informatics to understand the tiers of risk within a particular diagnosis, I think you get both physicians and healthcare systems as well as payers into a different mindset of how best to model the economics of care delivery, and probably can serve as the basis for the creative development of new risk-based payment schemes.