Kim Eason Explains Horizon's Use of Bundled Payment Model for Oncology

Oncology is a perfect fit for the bundled payment model, because it evaluates the outcomes, patient satisfaction, and cost of an oncology episode, said Kim Eason, manager at Horizon Blue Cross Blue Shield of NJ. She said that Horizon adopted the bundled payment model early to cope with New Jersey’s rising healthcare costs.

Transcript (slightly modified)

How can episode-based, or bundled, payments improve value and quality in cancer care?

We believe that episode-based payment can improve payments in any type of model, any type of specialty, and oncology care is no different from that. As we look at the shift in changing from fee-for-service to value-based care, oncology fits that model perfectly because it does look at specific services and events that happen to a patient along their care continuum, so we have the opportunity at Horizon to evaluate the total cost of care that patient is receiving within the oncology episode, their outcomes, and then their overall patient satisfaction.

Adoption of bundled payments has so far been fairly slow. Why did Horizon Blue Cross Blue Shield jump in so quickly?

The episode payment model, the reform, it’s really an evolution and not a revolution. So being slow doesn’t surprise us or surprise me, we believe it will take time for those changes to take place. But Horizon knew that inevitably something had to change. New Jersey has the 2nd highest healthcare cost in the nation and we could not continue to just look at cost rising and not figure out ways to address that, and then we decided to build our models around patient satisfaction, quality of care, and then the total cost of care. So that’s the reason why Horizon jumped in, because we knew we wanted to be there as the ground was breaking and not at the end of the event.