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5 Steps for Value-Based Oncology Care Success

Analysis  |  By Christopher Cheney  
   February 20, 2017

A Georgia-based oncology practice has embraced a multifaceted approach to shifting away from the fee-for-service business model to value-based care.

To succeed in the transformation to value-based care, John K. Hudson, MD, and his colleagues at Augusta Oncology have a plan.

Hudson earned his medical degree from the Augusta-based Medical College of Georgia and has been a practicing oncologist for more than two decades.

Below, he shares the five-step process that Augusta Oncology has adopted to support the practice's quest to succeed in providing value-based care.

1. View Value-Based Care as an Opportunity

The rise of value-based care opens a new chapter for oncologists and their practices, one with its own set of processes, requirements and measures.

But it's critical not to get overwhelmed and lose sight of the exciting opportunity before us. Value-based care promises to reinforce a whole-person, team-based approach that will significantly improve the quality, accessibility, and affordability of the care we deliver to cancer patients and their loved ones every day.

Meanwhile, applying the most advanced treatments with greater efficiency ultimately benefits everyone in our healthcare system.

2. Be Proactive in Adopting New Payment Models

At Augusta Oncology, we knew from the start that we wanted to engage early to both adopt and help shape emerging alternative payment models. We became one of 190 oncology practices from across the country selected for the Centers for Medicare & Medicaid Services Oncology Care Model (OCM).

The OCM enables us to deploy and extend patient-oriented services that address challenges we historically faced to delivering the highest quality care across all patients. In exchange, the OCM provides needed reimbursement for these services, helping keep patients safe while they fight cancer and away from costly hospital visits.

Similar programs are on the horizon for other specialties, and we recommend that practices actively engage them and consider involvement as part of their long-term value-based care success.

3. Prepare for Learning Curves

As oncologists assume holistic responsibility for the quality and cost of patient care, it is important to anticipate the new knowledge and capabilities that must reside in the practice.

Alternative payment models are about much more than adding new forms to an EHR or capturing metrics to populate and submit new reports. At Augusta Oncology, we have had to develop skills and capabilities to answer fundamental questions that support patient safety:

  • Who is at the highest risk?
  • How can we better support their complete health and well-being, across all conditions and settings of care?
  • How can we most effectively guide them when they need it most?

4. Commit to Practice Transformation

Putting value-based care knowledge and capabilities into action requires assessing a practice and how to optimize it for the new healthcare landscape—then enacting a plan for change.

Implementing the principles of population health management has been core to Augusta Oncology's journey. Specifically, we have focused on:

  • Greater patient engagement and education;
  • Addressing disparities in access to care; and
  • Providing increased support for navigating the healthcare system, clinically and financially.

The OCM has been a wonderful first step in helping us to deliver on these [principles]. For other practices in oncology and across specialties, the takeaway is to expect nothing short of practice transformation to optimize the results from these new skills, clinical capabilities and operations.

5. Rethink Partners and Tools to Support

The technologies that supported community-based oncology practices in the fee-for-service era often focused on charting and billing patient visits. As our practice has adopted value-based care, we've needed to be thoughtful in assessing how best to operationalize entirely new needs.

That has meant starting with a comprehensive vision of how we want to holistically support our patients across all settings, then looking for new partners with deep, dedicated subject matter expertise and tools.

For example, on the OCM front, we have implemented purpose-built technologies for value-based care coordination and management, advanced analytics, and registry and regulatory reporting to take our practice to the next level.

Christopher Cheney is the CMO editor at HealthLeaders.

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