PCN191 - Value-Based Care In Oncology: Challenges And Barriers Amongst Community Oncologists

Abstract

Reimbursement and payment models are rapidly shifting from volume to value where oncologists are increasingly being rewarded for reducing cost and improving quality. Barriers and challenges to the adoption of a value-based reimbursement model/ environment is not well-studied and is urgently needed for its success. During several live meetings conducted in 2017, US-based community oncologists from various geographic locations who represented various practice types were surveyed using an automated response system. Where appropriate, some questions allowed more than one answer. Questions centered on their understanding of various value-based care models, oncology care model (OCM), and payer/provider pathways. When asked to define value, most respondents equated value with better overall survival (75%) or improved quality of life (72%). When asked if they have already implemented value-based care initiatives in their practice, only 25% answered yes and 12% were not sure if any such initiatives have been implemented. Almost half of the surveyed physicians have not participated in a value-based care program; the top two programs among participants who have were the QOPI program sponsored by ASCO (31%) and the OCM (26%). While 58% of respondents strongly or somewhat agreed that implementing pathways can reduce the overall cost of cancer care, a large majority (41%) are not using pathway-directed treatments. Interestingly, practice-developed pathways were more often used than commercially developed ones. Despite 47% of physicians stating that their practices have the resources needed to implement advanced alternative payment models, only 8% are engaged with payers in these programs. Community oncologists define value as improvement in survival and/or quality of life. Despite value-based care being a major healthcare policy initiative, most oncologists lack the readiness and strategies necessary to properly implement value-based care initiatives and models. Additional resources are needed for successful implementation.