ASCO Releases Payment Reform Proposal to Support Higher Quality, More Affordable Cancer Care


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Robin Zon, MD, FACP, FASCO

With today’s health-care system in profound transition, it is critically important that payment systems provide medical practices with the flexibility needed to be compensated fairly and adequately.

—Robin Zon, MD, FACP, FASCO

ASCO released a proposal to significantly improve the quality and affordability of care for cancer patients. ASCO’s Patient-Centered Oncology Payment: Payment Reform to Support Higher Quality, More Affordable Cancer Care (PCOP) proposal is designed to simultaneously improve services to patients and reduce spending for Medicare and other payers.

“ASCO has developed a payment reform proposal that addresses the serious financial challenges facing today’s oncology practices, addresses the problems of affordability facing both payers and patients, and ensures that patients with cancer will be able to receive the full range of services that are critical to high-quality, evidence-based care,” said ASCO Immediate Past President Peter Paul Yu, MD, FACP, FASCO. “Furthermore, we believe that PCOP would qualify as an alternative payment model, thereby helping to advance federal goals for improving the quality and affordability of health care.”

According to ASCO, the PCOP proposal would meet the definition of an Alternative Payment Model as set out in recently enacted legislation that repealed Medicare’s Sustainable Growth Rate formula. The Medicare Access and CHIP Reauthorization Act of 2015 encourages development of alternatives to the current Medicare fee-for-service payment system as a strategy to achieve higher quality, more affordable care. 

ASCO’s proposal addresses major problems in today’s fee-for-service system, such as inadequate payment for the wide range of services critical to supporting patients with cancer, and managing a complex illness that often changes from day to day.

The proposal acknowledges that oncology practices across the United States have different capabilities and face different challenges depending on their individual marketplace and practice environment. It provides examples of three different payment systems that practices can choose to adopt, all of which would cover many more cancer care services not currently covered by Medicare.

“With today’s health-care system in profound transition, it is critically important that payment systems provide medical practices with the flexibility needed to be compensated fairly and adequately—preventing disruption to the care we provide patients, allowing physicians to tailor services to the unique needs of individual patients, and without increasing financial burdens on patients,” said ASCO’s Past Clinical Practice Committee Chair Robin Zon, MD, FACP, FASCO. “ASCO’s Patient-Centered Oncology Payment proposal not only provides that flexibility, but also introduces much-needed stability into cancer care, to ensure that patients receive the full range of services they need to fight their disease.”

The PCOP proposal incorporates extensive input that ASCO received on an earlier draft proposal, Consolidated Payments for Oncology Care (CPOC), which was released in May 2014. Over the past year, many ASCO members and other stakeholders have endorsed the need for payment reform in oncology and provided suggestions on ways to improve the CPOC model—input used to develop the PCOP proposal.

ASCO is soliciting comments on its payment reform model through July 20, 2015. For more information and the complete text version of the ASCO payment reform model, please visit
www.asco.org/paymentreform. ■

© 2015. American Society of Clinical Oncology. All rights reserved.

 



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