Since the last two decades, oncology treatment has transitioned from a system based on monetary value evaluated to values mainly derived from a patient’s perspective. The new Oncology Care Model (OCM) was envisioned in 2016 to streamline practices according to patient-centered care—values crucial to patients.
The decision to incorporate patient-centric care is a significant milestone in oncology. It encourages active collaboration and coordination between payers and providers to ensure that the treatment puts patients first. According to the National Comprehensive Cancer Network CEO, the patient’s voice is often unheard despite much talk about the value. Therefore, value-based care is a model that puts the patient first by trying to deliver the quality of oncology treatment envisioned by the patient.
Among the most critical problems that Oncology Care Model tries to address are financial issues faced by patients, lack of shared-decision making by stakeholders, and psychological constraints such as transportation and work disruption.
Addressing Financial Constraints
Managing patient visits is the critical component that can control cost. For instance, the program aims to generate awareness among patients regarding when to visit an emergency room, see an oncologist, and consult with the doctor over the phone. Participants in the value-based model have established strategies, such as “Call Us 1st”, to help patients make decisions. Now, patients can call “Call Us 1st” helplines to receive practical advice on the phone rather than wasting finances to travel to remote locations searching for the optimal solution.
While such meaningful strategies may seem trivial in the face of increasing healthcare costs, these are backed by years of data collection. According to Brian Connell, Executive Director, Federal Affairs, Leukemia & Lymphoma Society, it just takes $2,000 for almost 45% of the patients to drop out of a treatment program. Under such circumstances, value-based models are critical to reducing cost because they address patients’ finances at the micro-level.
Enhanced collaboration among stakeholders is another critical component of community oncology and patient-centric care. Routine meetings, seminars, and active communication allow cancer care providers to maintain high levels of coordination, ensuring that everyone is on the same page regarding the patient’s treatment, progress, and medical history. By focusing on similar goals, clinical and non-clinical members can ensure that patients’ needs are met in time.
“Project Patient Voice” is one of the programs that has proven effective in offering value-based patient care. It gives participants access to patient-reported outcomes from clinical trials shared among healthcare providers. Similarly, the Oncology Center of Excellence identifies ways to improve the development of clinical trials by bringing such trials to patients and creating a more user-friendly medical terminology that patients can easily understand.
Resolving Psychological Issues
Psychological issues arising from financial constraints and medical treatment are commonplace among patients treated with cancer. Carla Tardif, Chief Executive Officer of Family Reach, suggests that almost one-third of the patients who cannot afford treatment cut their medication in half. This is due to the additional expense that indirectly affects the patient, such as child care, transportation costs, and taking time off from the workplace.
To deal with psychological problems, community oncology, and value-based patient care aim to foster an environment of open and honest conversation between the health provider and their patients. Honest communication is critical for patients who may experience treatment side-effects such as erectile dysfunction and urinary incontinence. Similarly, it offers training and guidelines in dealing with discriminatory practices against LBGTQ+ communities.
In 2022, the value-based care will transition from OCM to OCF, Oncology Care First, model. The OCF model builds on the experiences of OCM and will try to address any underlying concerns that OCM omitted. According to the National Law Review, OCF will expand the number of beneficiaries. Instead of including patients treated for chemotherapy, it will consist of patients with hemotherapy, hormonal therapy, or without cancer drugs.
OCF also simplifies the payment process by offering transparency in complicated MPP calculations. It facilitates OCM’s historical MEOS payment into one simple MPP. OCF will also help by calculating novel drug adjustments based on the type of cancer. The process will allow patients paying for high-cost drugs to take advantage of the new model.
Overall, the value-based care model has proven its effectiveness relatively quickly. It’s here to stay because future oncology models such as OCF will help healthcare providers protect communities by relying on improved data, better guidelines, and practical strategies based on patients’ perspectives.
About Verdi Oncology
Verdi Oncology is an oncology practice management company that defines value from the patient’s perspective. We provide innovative solutions and support to empower medical experts and the patients they serve. The Verdi Network works with practices, physicians, hospitals, and value-based contracting entities to create the future of cancer care.