In the healthcare industry, Value-based healthcare is the new delivery model in which care providers, including hospitals and physicians, are rewarded for helping patients improve their health and are paid based on patient health outcomes.
This model has great adoption in the Oncology for delivering holistic patient care while driving sustainable cost savings. In this model participating practices need to track and report on a vast array of new measures related to care quality, cost, and patient outcomes.
These programs, such as the Oncology Care Model (OCM), offer financial incentives to participants as well as practices that are compelled to develop and deploy new capabilities for patient care.
However, Most Oncologists are optimistic about the beneficial potential of value-based care; until they observe a conflict between the need to decrease episode costs and the rising prices of the most innovative novel therapies.
Hence new trends are emerging in value-based care of Oncology:
Cost of drugs
Rising drug costs including promising but expensive novel therapies as the challenge in the era of value-based care make practices financially accountable. Also, continuous rising drug costs as a priority issue impacting the overall wellbeing of practices.
New approaches to the treatment of cancer
Oncologists are choosing treatment regimens under value-based care programs where they are accountable for the cost of entire episodes of care as well as about drug choices, compared to their approaches during the fee-for-service era.
The oncologist is remaining committed to delivering the best clinical outcomes while choosing a drug for an individual patient’s treatment regimen irrespective of the impact on episode cost.
Cooperation among various stakeholders under the value-based care model
The value-based care model is driving the need for cooperation among providers, pharma, and payers. This cooperation enables Oncologists to match the right treatments with the right patients under the value-based care model. The oncologist is looking for help to figure out how to optimize treatment decisions for the new landscape.
The emergence of care pathways
A care pathway which is a multidisciplinary healthcare management tool based on healthcare plans for a particular group of patients in which the different tasks or interventions are involved by the professionals in the patient care with a predictable clinical course. Care pathways will play a pivotal role in Value-based care model and there is a need for active use of care pathways by integrating them into value-based reimbursement models.
Precision medicine is an approach to patient care that allows doctors to select treatments that are most likely to help patients based on a genetic understanding of their disease. This approach ultimately resolves the growing tension between drug costs and will act as a key to the appropriate use of novel therapies for cancer in the future.
Rising Patient’s awareness
Nowadays, traditional referral patterns are disrupting as patients are becoming more independent. Moreover, various factors that are driving this patient consumerism, including a growing price sensitivity by consumers, increased access to healthcare information that they can use for their decision-making and rising expectations for services and subsequent changes like the physician-patient relationship.
Medical Billers and Coders (MBC) providing Oncology coding and billing services to several companies across the US. Our expert team has years of expertise in this field and outsourcing your Oncology coding and billing to us, you may rest assured that the process is being handled by trained professionals.