Maintaining Oncology Cost Savings: 3 Challenges in Value-Based Care

October 11, 2019

What to consider when balancing cost and quality in oncology care.

The transition to value-based care models is steering physicians away from the traditional quantity-centric parameters of the fee-for-service model, and into comprehensive and individualized care.

This shift is especially beneficial to oncology patients, who are positioned to benefit extensively from a comprehensive care model that allows for personalized care coordination. The complex care needs of oncology patients are best met by an all-encompassing, overarching approach that coordinates resources for comprehensive support.

However, delivering such high-quality, patient-centered care can be complicated for oncologists who also need to maintain the meaningful cost savings necessary to meet the targets of the value-based care programs-particularly as cancer treatment costs continue to rise.

Here are three things to consider regarding the challenges of balancing cost and quality in oncology care.

1. Rising drug prices.

A recent survey performed by Integra Connect surveyed 530 oncologists participating in value-based care programs. Overwhelming, the respondents stated that rapidly increasing drug prices are making it increasingly difficult to keep costs down. 57% of those surveyed cited rising drug costs as the biggest challenge for value-based care models. 87% said that these models make them reconsider drug choices.

As a result, 38% of the surveyed oncologists reported wanting a deeper understanding of drug value and therapy impact, so that they could make better-informed choices to optimize treatment decisions to both benefit patients and also keep costs in acceptable ranges. In fact, half of oncologists said that receiving better data about both cost and care quality would help them make more informed treatment decisions. However, 66% responded that pharma companies have been “not helpful at all” in helping them learn about the holistic value-not just the cost-or their drugs.

Related:How Value-Based Care Changes The Provider Staffing Model

2. Unestablished or underutilized clinical care pathways.

Following and adhering to clinical pathways has been shown to lower cancer-care costs. Pathways optimize workflows to make them more efficient, and are a way to reduce extraneous treatment variability, standardize care and improve outcomes.

However, the survey discovered that 66% of oncologists aren’t utilizing pathways, because they either don’t have access to them, or choose not to follow them. This underutilization-and inaccessibility-can compromise productivity, resulting in added costs. As the value-based care model grows and develops however, 86% of those surveyed reported seeing a role for clinical pathways in their practice in the next two years.

3. Shifting treatment protocols

75% of the oncologists surveyed by Integra Connect said that cost targets of value-based care have influenced them to make changes to how they choose treatment regimens, in comparison to their approaches under a fee-for-service model. As lowering costs-without sacrificing patient care-becomes a priority, physicians need to embrace comprehensive care that offers solutions before costly interventions become necessary.

For example, avoiding expensive hospital admissions can reduce cancer care costs. Providing more access to outpatient care, conducting advance care planning and offering disease management programs can lower hospital admission rates. Strategies such as care coordination and palliative care can not only reduce emergency room visits and hospital stays, but also improve a patient’s quality of life.

Implementing these programs and creating care networks can be costly in the transition phase, but will, in the long run, make value-based care models financially sustainable for oncologists. Integrating these strategies into treatment plans can help keep costs down, while also providing improved patient care.

Laura Dorr is a freelance writer based outside of Cleveland, Ohio. She has served as a writer and editor for a variety of publications and websites across the medical, dental, sports, education, and nonprofit industries.