The pay for value revolution is here, and it means significant changes to the way primary care is provided to patients. But what does it mean for specialists?
In risk-based contracts, primary care providers such as family physicians, pediatricians, OB/GYNs and internists are relied on to keep patients healthy and well. Meanwhile, the industry is still trying to determine how specialists fit into the risk-based model.
One organization may have cracked the code about how oncologists integrate into a fee-for-value environment. The Vantage Cancer Care Network (VCCN) is an organization that partners with oncology clinics to improve patient care through an integrated, multi-specialty approach, where identifying the most important treatment regimens allows for more personalized patient care while also combating rising oncology costs.
“The current shift [to fee-for-value] further hurts a field that is built to grow on pay for service, not a quality of care model,” said Ben Slocum, VCCN president. “Right now, oncology pays on what is done, not how good the care is performed.”
“Cancer costs are rising two times faster than health care costs,” said John Iacuone, MD, VCCN chief clinical officer. “It’s not a model that will last. Oncology care is something that doesn’t, right now, fit the shifting volume-to-value model, and because of that, we had to create a solution.”
VCCN takes on oncology-specific risk contracts through strong relationships with payers, improved provider coordination, and by finding ways that allow their specialty physicians to maintain their focus on providing high-value clinical functions. It’s a new vision of care, finance and approach to attaining long-term results for physician specialists that match the market and its shift to value-based care.
For payers, contracting through the network increases the predictability of cancer treatment costs, and provides data on quality of care provided compared to standard oncology performance metrics. Payers can know that patients are getting better value at a lower cost, with quality outcomes.
Providers contracted through VCCN are able to move away from care options being managed by payers, and instead work within a patient-centered oncology home, where the medical oncologist acts like the primary care doctor in a specialty situation.
And with payers able to pay for quality of care and providers being reward for good care, patients benefit. The network can also make care more community-based, making it easier for patients to access care as needed.