Doctors treating cancer patients will be paid based on the value of the care they deliver rather than the volume of services they provide, under a new Affordable Care Act program announced by the Department of Health and Human Services (HHS) Feb. 12.
HHS said the new multi-payer payment and care delivery model is aimed at improving the quality of care patients receive, spending health care dollars more wisely, and contributing to healthier communities.
The initiative will include giving patients undergoing treatment 24-hour access to practitioners.
Each year more than 1.6 million Americans are diagnosed with cancer. The financial in 2010 was estimated at estimated $263.8 billion in medical costs and lost productivity. The majority of those diagnosed are Medicare beneficiaries over 65 years old.
The program, called the Oncology Model, is one of a number of innovative payment and delivery models developed by the Centers for Medicare & Medicaid Services (CMS) with input from physicians, patients and the private sector.
CMS is in discussions with commercial insurers, Medicare Advantage plans, state programs, and managed care plans about adopting the model.
HHS said the Oncology Care Model aims to improve care and lower costs through performance-based payments that financially incentivize high-quality, coordinated care.
Physicians will also receive monthly care management payments for each fee-for-service beneficiary to support delivery of comprehensive, coordinated patient care.
The introduction of the new model for cancer care payments comes about two after HHS Secretary Silvia Burwell announced a goal tying 30% traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models by the end 2016, and 50% by the end of 2018.
For hospitals, HHS also set a goal tying 85% of all traditional Medicare payments to quality or value by 2016 and 90% by 2018. These are the first explicit goals HHS has set for alternative payment models and value-based payments.
