Skip to main content

Illinois Community Practice Reduced Cancer Drug Spend by 13.5%

Analysis  |  By Jack O'Brien  
   May 15, 2020

The authors concluded that a reduction in drug spending "is possible within a value-based care model" reliant on evidence-based pathways.

An Illinois cancer treatment center reduced its spending on cancer drugs relative to the Oncology Care Model (OCM) by 13.5% through value-based clinical pathways, according to a study published in the Journal of Oncology Practice Friday.

From Q1 2017 to Q1 2019, Cancer Care Specialists of Illinois (CCSI) saw its median cancer drug spending increase by 18.6% compared to the OCM spending increase of 34.4%. Similarly, from October 2017 to December 2019, CCSI's pathway adherence rose from 69% to 81%.

The study sought to challenge the notion that oncologists are unable to control cancer drug spending, with the authors concluding that a reduction "is possible within a value-based care model" reliant on evidence-based pathways.

The study's authors do concede that the results are "subject to potential confounding influences that may be confused with treatment effect," as well as the fact that CCSI's "higher-than-median chemotherapy spending at baseline" could have contributed to an easier descent to median drug spend.

Related: Oncologist Who Led AMA Has Prescription for U.S. Healthcare Challenges

"Although segregating out the contribution of each of these factors is difficult, we have shown that reduction of drug spend using clinical pathways to optimize chemotherapy utilization is possible and can increase the chances of a practice’s success within the OCM model," the authors wrote.

Related: Oncology Care Model Kicks Off

Related: Stakeholders Rap CMS Mandatory Radiation Oncology Model

The study's findings were released amid the ongoing coronavirus disease 2019 (COVID-19) outbreak, which has prompted healthcare stakeholders to consider the potential opportunity for alternative payment models (APM) to mitigate the damage.

Keely Macmillan, senior vice president of policy and solutions management at Archway Health, a Boston-based payment solutions company, told HealthLeaders last month that the ongoing outbreak is an opportunity to examine how providers participating in APMs continue to deliver value-based care during a crisis.

Providers participating in APMs such as accountable care organizations, Bundled Payments for Care Improvement, or OCM already have the benefit of telehealth waivers, according to Macmillan.

Providers that have been operating under these waivers, Macmillan continued, are likely to have already established the necessary infrastructure to support telehealth services ahead of the demand surge spurred by the COVID-19 outbreak.

Related: 4 Coronavirus Financial Considerations for Health System Leaders

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.

Get the latest on healthcare leadership in your inbox.