Dr Mark Fendrick Previews VBID Panel Discussion at COA Payer Exchange Summit

During the upcoming Community Oncology Alliance (COA) Payer Exchange Summit, a panel discussion on applying value-based insurance design (V-BID) in oncology will explore ways in which the coronavirus disease 2019 (COVID-19) crisis can be an opportunity for re-evaluation, said Mark Fendrick, MD, co-editor-in-chief of The American Journal of Managed Care®, and director of the University of Michigan Center for Value-Based Insurance Design.

Transcript

What are key issues you plan to raise in the COA panel discussion on applying V-BID to oncology?

The COVID pandemic has put a lot of fiscal pressure on health care providers, patients, as well as those who pay for care. As we emerge from the pandemic, it's very important that patients get the care they need, but hopefully not get care that will not make them healthier. So one of the focuses of our panel in the upcoming COA Payer Summit is actually how we might be able to turn the COVID crisis into an opportunity, such that we might be able to implement strategies that will allow us to spend more money on the prevention, monitoring and treatment of cancer patients and deter the use of those services that do not make those patients any healthier.

Do any of the issues in health care that the pandemic has highlighted have implications that could be applied to the discussion of V-BID in cancer care?

Obviously, many public and private payers have taken a serious financial hit since the pandemic begun, and they're scrutinizing even more their health care spending. I've been worried that there'll be a resurgence of these blunt instruments, like high deductibles, that prevent patients from getting the care they need as well as the care they don't need. And we're hopeful that we might be able to apply more nuanced payment strategies and benefit designs that will allow my patients and providers to provide the care that we know is evidence based and will improve patient-centered outcomes, but also put levers in place to make sure that the care that was just provided because we could and didn't make patients any healthier would not return to levels that they were at before the pandemic.

Our editorial on turning COVID-19 crisis into opportunity can be found at AJMC.com.

Are there any unique challenges when it comes to aligning quality and economic goals with V-BID for oncology care?

So, cancer is complicated from the delivery of care, the payment of care, and certainly the navigation of an individual patient. Not only do we have the typical challenges that patients may face, we also have concerns over the increased risk of coronavirus, infection, and COVID-related diseases, particularly for those patients who are at high risk for not only getting their condition but actually having a poor outcome. So on top of our usual attempts to spend more money and allow access and affordability to those services that will improve the lives of cancer patients, we have this added element of the coronavirus that early on has led to significant declines in cancer screenings, cancer diagnoses, cancer treatments, as well as enrollment into cancer trials. So the oncology community has great challenges, but also opportunities to re-look at their practices. And understand that we're going to be highly scrutinizing what we do first in terms of patient safety and outcomes, and second in terms of how we're spending our scarce financial resources.