Dr Joseph Alvarnas on Importance of Patient Voice in Value-Based Cancer Care

The transformation to value-based oncology care must be centered upon the priorities and needs of patients and their families, said Joseph Alvarnas, MD, of the City of Hope and editor-in-chief of Evidence-Based Oncology. This vision is starting to be incorporated in areas like the Oncology Care Model, which looks at patient-reported outcomes and experiences.

Transcript (slightly modified)

How can the shift to value-based cancer care incorporate the voice of the patient?

We’ve been in the middle of very complex times as healthcare makes this dramatic transformation. In a lot of ways, we’ve seen 2 forces clash in this idea of medicine as a profession that can become more efficient, more systematized, and this other idea of medicine being a craft-based profession. For the last few years, since the passage of the Affordable Care Act, that idea of the economics that surround cancer care and the complexity of care delivery have tended to dominate the conversation.

More recently, though, I think what you’ve heard as people think about systems of care delivery and value-based care, there’s been a refocusing on what I think is most important in that equation, which is putting the patient at the center of that arc. That this idea of value-based care isn’t something about resource utilization, it isn’t something about care pathways, absent having those things grounded in a vision of a person.

So when we look at value-based care, I think the equation really is one that’s centered upon the priorities and needs of patients and their families. The idea that we can in fact take someone who years ago may have been incurable and offer them state-of-the-art therapeutics in an economically sustainable way that can lead to them being restored to a sense of wholeness, represents what I think is the most complete arc of what represents patient-centered oncology but also this idea of value-based care.

And I think you’re beginning to see this reflected in a number of areas, including the Oncology Care Model, which is looking carefully at patient-reported outcomes. I think you’re seeing it from various payers who are looking for patient-reported experience of care as a marker of the adequacy and wholeness of care delivery.

So I think as we think about value-based care in a meaningful way, ideally it begins and ends with the vision of how best to serve the patient, with a balance between technology, the cost of technology, and the nature of care delivery.