CMS’ Oncology Care Model program is bringing bundled payments to cancer care. With drug costs so high and hard to control, the 195 participating practices will have to figure out other ways to control costs if they want to beat financial benchmarks and earn bonuses.
Experts are rethinking routine cancer screening. Genetic tests could be the answer. They may add upfront expense, but might eventually lead to savings by winnowing out unnecessary screening. Concern about false positives helps push this movement along.
Sometimes it’s best to hold off. Patients and doctors fight the urge to rush in and treat as more types of cancer lend themselves to active surveillance. The advent of precision medicine makes this a more inviting option.
The intrepid young oncologist’s criticism of cancer screening and surrogate endpoints has stirred up controversy. Prasad thinks that providers should offer medical therapies that do more good than harm. “I mean things that matter to people, which is living longer, living better.”
Health plans can’t just weather the storm, they need to keep an eye on the future when it comes to a rating system that’s constantly evolving. The bar has been set higher as Stars becomes permanent. Integrated health care benefit designs have proven to be a boon.