Creating a rapid, continuous learning environment for oncology payment reform
As value-based medicine emerges as the new paradigm for the US healthcare market, the Optimal Oncology APM initiative engaged oncology leaders to understand successes and lessons across alternative payment models (APMs) in this specialty. Tapestry collaborated with provider representatives and associations, technology experts, payers, patient advocacy organizations, and others on a discussion platform for rapid learning across ongoing and proposed oncology APM pilots.
The platform—an informal advisory council of key innovators in oncology payment reform—served as a sounding board to align objectives across pilots, share pain points, and identify fast fails. It also served as a forum to bring in relevant expertise for solving the identified pain points. The oncology APMs advisory council was formed in June 2018, met on an ongoing basis through 2021 and was supported by Amgen and co-hosted by the American Cancer Society.
A subset of the council collaborated on a multistakeholder coauthored commentary published in the American Journal of Managed Care in 2022. The article discusses lessons from commercial-sector oncology APM experiments to date.
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Relevant publication: Elizabeth Shaughnessy, David C. Johnson, Aaron J. Lyss, Ravi B. Parikh, Steven R. Peskin, Blase N. Polite, et al., “Oncology Alternative Payment Models: Lessons From Commercial Insurance,” American Journal of Managed Care 28, no. 3 (2022), 98-100.
Some of the council participants continue to explore future similar collaborative efforts as oncology APMs continue to evolve.
Project Background:
In March 2018, Tapestry Networks convened an initial meeting to address key pain points in oncology APMs and potential solutions for those pain points. The March workshop prompted discussion on the need for a collaborative platform to address the identified issues across APMs in oncology. While there are other such forums in payment reform, participants determined that a forum specific to oncology would be beneficial given the complexities involved in designing and implementing APMs in this specialty and the many disparate current and proposed pilots under way.
PUBLICATIONS
April 2021 As the Biden administration carves out its approach to healthcare policy, some healthcare thought leaders are reflecting on the successes and failures of recent experiments in paym
November 2020 As details on the Center for Medicare & Medicaid Innovation’s (CMMI) new Oncology Care First (OCF) model remain undecided, participants of the oncology alternative payment mode
July 2020 COVID-19 prompted oncologists across the United States to rapidly deliver new interventions and policies to protect their patients and workforce. As the acute crisis abates in some
