NcXHF

THE PATIENT-CENTERED MEDICAL HOME
care and the value created. These important organizations
could continue to provide leadership by collaborating to develop
a core set of cancer care standards, elements, and features
to enhance the focus, minimize the confusion, and
shorten the timeline for adoption of new cancer care models
within the payer and provider communities. Unifıcation and
working toward common patient and provider goals will enhance
adoptability, and, therefore, scalability.
CONCLUDING REMARKS
Innovative payment models in cancer care are getting increased
attention from all oncology stakeholders, including
CMS, private payers, providers, drug manufacturers and distributors,
hospitals, professional societies, and, importantly,
the patients. Faced with spiraling costs, regulatory burdens,
impaired access to treatment, and ineffıciencies of care there
has been a driven focus on delivering cancer care with greater
value to all the stakeholders. The OPCMH concept has now
been shown to be a viable foundation for carrying out
quality-driven, cost-effective comprehensive management of
patients with cancer. Much of the value gained from the
OMH infrastructures comes through refınement of day-today
patient care processes resulting in superior outcomes.
Practices should be held accountable to quality practice standards
through established and developing accreditation standards
through entities such as NCQA and COC, as well as
adherence to recognized treatment guidelines and pathways.
The further development of these quality metrics should be
evidence-based, succinct (clinically relevant), advocate the
patients’ best interests, and with expert consensus from all
stakeholders.
As it becomes acutely apparent that a major element of
health care reform is to move away from FFS to varieties of
bundled payment options, we believe that the PCMH models
in oncology can provide the stable infrastructure required to
mitigate the inherent fınancial risks of bundled payment, episodes
of care, and share savings payment options. However,
without payer support, further attrition of community-based
practices can be anticipated, resulting in escalating costs
and a decline in the value of cancer care. It is important for
payers and policymakers to understand that for providers
to implement substantive practice management changes
that provide higher quality care at lower costs under a system
other than FFS, it is mandatory that the fınancial value
of uncompensated comprehensive services provided
through an OMH program be recognized to be sustainable
and scalable.
Disclosures of Potential Conflicts of Interest
Relationships are considered self-held and compensated unless otherwise noted. Relationships marked “L” indicate leadership positions. Relationships marked “I” are those held by an immediate
family member; those marked “B” are held by the author and an immediate family member. Institutional relationships are marked “Inst.” Relationships marked “U” are uncompensated.
Employment: Barbara L. McAneny, NMOHC. Lee N. Newcomer, UnitedHealth Group. Leadership Position: Barbara L. McAneny, AMA. Stock or Other
Ownership Interests: Lee N. Newcomer, UnitedHealth Group, UnitedHealth Group. Ray D. Page, Oncology Metrics. Honoraria: None. Consulting or Advisory
Role: Barbara L. McAneny, Genentech, Lilly Oncology. Ray D. Page, International Oncology Network, Via Oncology. Speakers’ Bureau: Ray D. Page, Biodesix,
Celgene. Research Funding: Ray D. Page, Bristol-Myers Squibb, Celgene, Genentech/Roche, Gilead Sciences, Pfizer. Patents, Royalties, or Other
Intellectual Property: None. Expert Testimony: None. Travel, Accommodations, Expenses: Barbara L. McAneny, ASCO, COA. Ray D. Page, RainTree.
Other Relationships: None.
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