Keeping up with the rapidly changing landscape of cancer care

Stephanie GingerPatient-centered Care, Value-based Care

The American Journal of Managed Care recently hosted the Patient-Centered Oncology Care Conference in Philadelphia. The theme of this meeting was “Innovation and Quality: New Direction in Value-Based Care” and it was comprised of a full day of presentations from thought leaders and panel discussions with key innovators in cancer care.

Advancing Technologies for Cancer Detection and Care

To open the conference, keynote speaker Joshua Ofman, MD, the Chief of Corporate Strategy and External Affairs for GRAIL, presented the blood test his company is developing that combines high-intensity genomic sequencing and complex computational algorithms to detect cancer earlier with fewer false positives. It was really exciting to see progress in detecting deadly cancers before they are too advanced for treatment. In the following presentations it didn’t go unmentioned that new technologies and treatments, including CAR T therapy and other immunotherapies, are exciting, but also challenging for providers with ambiguity around reimbursement and the need for more data to better understand the value of new and expensive treatments.

Improving the Patient Experience

The day, of course, kept a steady focus on the patient experience. Rebecca Kaul of MD Anderson pointed out that Amazon and Apple are coming to disrupt healthcare not because of their healthcare expertise, but because they understand what people need and want. Her center put together a patient counsel to identify how they could do better. As a result they have redesigned the patient’s first appointment experience focusing on human interaction, efficiency, and coordination.

A panel discussion after that looked at personalized medicine through the lens of value-based care. One panelist put it this way: personalized medicine is diagnostics to prescribe the right therapies combined with the patient’s values, history and circumstances. The challenge, though, is figuring out strategic ways to regulate, reimburse, and gain clinical adoption of this approach to care.

What Does the Future Hold?

Another key theme was what the future holds. What will happen with advanced payment models and how can cancer care providers stay afloat under new administrative burdens and rising drug and novel therapy costs? There was generally agreement that patient-reported outcomes will become a standard part of care, although how it would be enabled and paid for was unclear. The panel discussion on the future of APMs included general consensus that the Oncology Care Model was a great first step in redefining cancer care delivery, but it’s a flawed model in that it doesn’t take into account geography, patient mix, the cost of some therapies and other factors that can sink performance. In looking to what’s next, there was an emphasis on getting providers and payers to the same table to design new models together. Some saw promise for CMMI’s proposed Oncology Care First Model, but others were skeptical as it’s too light on the details at this time for providers to understand their risk.

There was much more shared throughout the day and the spirit of collaboration among these dedicated cancer care providers was apparent as they spoke of the challenges they face everyday and the opportunities they see for redesign and innovation. Improving cancer care is too complex and important to go it alone.