In the ever-evolving landscape of oncology care, embracing innovation and creative problem-solving have become crucial factors for success. At the 2023 Community Oncology Alliance Annual Meeting, a panel discussion tackled the complexities and opportunities associated with implementing value-based care and shared-risk arrangements within the field of oncology.1
The session called “Thinking Outside the Box” featured panelists Brad Hively, Chief Executive Officer of the Oncology Institute; Alti Rahman, MHA, MBA, CSSBB, Practice Administrator, Oncology Consultants; Sibel Blau, MD, Medical Director, Northwest Medical Specialties, and Chief Executive Officer, Quality Cancer Care Alliance Network; and moderator Stephen “Fred” Divers, MD, of Genesis Cancer & Blood Institute & American Oncology Network.
Navigating Value-Based Care and Shared-Risk Arrangements
The panelists first shared their insights on navigating both value-based and fee-for-service models and the significance of obtaining the right contracts to reward providers for the savings they generate. According to Mr. Hively, a delicate balance must be maintained when transitioning from a volume-based to a value-based model to avoid negatively impacting a practice’s profitability. “It’s crucial to have the right contracts in place to ensure that providers are rewarded for the savings they generate,” he said.
Mr. Hively also underscored the need for oncology practices to grow and collaborate to share risk effectively. “By expanding and collaborating, larger practices can better manage and spread risk across more extensive patient populations, making them better equipped to handle the uncertainties associated with expensive treatments and rapidly evolving treatment protocols,” he commented.
Mr. Rahman acknowledged that the implementation of value-based care arrangements is heavily influenced by market dynamics, payer mix, and the overall health ecosystem. Despite the challenges that come with managing multiple value-based–care arrangements, he stressed the importance of embracing these models to stay competitive in the market and provide the best possible care for patients. “The key to success is to adapt to the market by working with payers to implement various models, including episodic, bundle payments; sub-cap arrangements; as well as Oncology Care Model and Enhancing Oncology Model plans,” he said.
Evolution and Innovation in Oncology Practices
According to Dr. Blau, implementing value-based–care models requires a significant cultural shift within the practice, involving not just physicians but also staff and the technologic infrastructure. Dr. Blau shared her experience with the development of value-based enterprise arrangements with local health systems, emphasizing the need for collaboration and learning from others within the Quality Cancer Care Alliance Network.
“The goal of these partnerships is to save costs and improve care quality by implementing value-based–care efforts, such as utilizing clinical pathways and other cost-saving measures,” said Dr. Blau. “However, there are legal and logistical issues that need to be resolved before value-based enterprise partnerships can be finalized.”
“Evolution is critical,” Dr. Blau continued. “You must be able to evolve within the process by focusing on finding the right leadership, working on clinic culture, and utilizing data effectively.”
The panelists also shared their experiences with different marketing approaches, highlighting the importance of being accessible to a diverse patient population and building relationships with primary care physicians and specialists who share their commitment to cost-effective, high-quality care. “Strong physician and nursing leadership is vital in combining the technical aspects of value-based care with the patient experience,” Mr. Rahman added.
Ways to Improve Patient Care and Outcomes
The discussion concluded with the panelists sharing various innovative approaches they have implemented in their practices to improve patient care and outcomes.
Mr. Hively highlighted the importance of expanding partnerships with universities beyond traditional medical programs. By collaborating with informatics and analytics programs, they have been able to integrate students with diverse backgrounds into their practice, ultimately accelerating the development of their digital front door for patients. According to Mr. Hively, this shift has enabled the practice to offer both analog and digital communication options for patients, improving overall accessibility and convenience.
Mr. Rahman focused on adopting a public health lens for his practice. “By incorporating public health perspectives, we have been able to develop health equity initiatives focused on prospective social determinants of health screening,” he said. “This approach has led to the creation of an artificial intelligence system to enhance clinical care, which has generated enthusiasm among the team.”
Dr. Blau emphasized the importance of centralizing research and improving access to clinical trials. The Quality Cancer Care Research Network, now part of the exigent research collaboration, aims to reduce administrative burden, improve the quality of care, and increase access to clinical trials for underserved populations. “By building a data warehouse and developing intelligent tools, we hope to streamline the research process and make it more accessible for community oncology practices,” said Dr. Blau.
Overall, the panelists emphasized the importance of thinking outside the box and embracing innovation in all aspects of their practices. By doing so, they have been able to improve patient care, increase access to clinical trials, and drive meaningful change in the oncology landscape.
DISCLOSURE: The panelists reported no conflicts of interest.
1. Divers SF, Blau S, Hively B, et al: Thinking outside the box: Going beyond the ‘traditional’ model of the community oncology practice. 2023 Community Oncology Alliance Annual Meeting. Presented March 23, 2023.