Studies from T. Valuck et al Add New Findings in the Area of Managed Care (Improving Oncology Quality Measurement in Accountable Care: Filling Gaps…

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Studies from T. Valuck et al Add New Findings in the Area of Managed Care (Improving Oncology Quality Measurement in Accountable Care: Filling Gaps with Cross-Cutting Measures)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Investigators discuss new findings in Managed Care. According to news reporting from Baltimore, Maryland, by VerticalNews journalists, research stated, "Payment for health care services, including oncology services, is shifting from volume-based fee-for-service to value-based accountable care. The objective of accountable care is to support providers with flexibility and resources to reform care delivery, accompanied by accountability for maintaining or improving outcomes while lowering costs."

The news correspondents obtained a quote from the research, "These changes depend on health care payers, systems, physicians, and patients having meaningful measures to assess care delivery and outcomes and to balance financial incentives for lowering costs while providing greater value. Gaps in accountable care measure sets may cause missed signals of problems in care and missed opportunities for improvement. Measures to balance financial incentives may be particularly important for oncology, where high cost and increasingly targeted diagnostics and therapeutics intersect with the highly complex and heterogeneous needs and preferences of cancer patients. Moreover, the concept of value in cancer care, defined as the measure of outcomes achieved per costs incurred, is rarely incorporated into performance measurement. This article analyzes gaps in oncology measures in accountable care, discusses challenging measurement issues, and offers strategies for improving oncology measurement. Discern Health analyzed gaps in accountable care measure sets for 10 cancer conditions that were selected based on incidence and prevalence; impact on cost and mortality; a diverse range of high-cost diagnostic procedures and treatment modalities (e.g., genomic tumor testing, molecularly targeted therapies, and stereotactic radiotherapy); and disparities or performance gaps in patient care. We identified gaps by comparing accountable care set measures with high-priority measurement opportunities derived from practice guidelines developed by the National Comprehensive Cancer Network and other oncology specialty societies. We found significant gaps in accountable care measure sets across all 10 conditions. For each gap, we searched for available measures not already being used in programs. Where existing measures did not cover gaps, we recommended refinements to existing measures or proposed measures for development. We shared the results of the measure gap analysis with a roundtable of national experts in cancer care and oncology measurement. During a web meeting and an in-person meeting, the roundtable reviewed the gap analysis and identified priority opportunities for improving measurement. The group determined that overreliance on condition-specific process measures is problematic because of rapidly changing evidence and increasing personalization of cancer care. The group's primary recommendation for enhancing measure sets was to prioritize and develop effective crosscutting measures that assess clinical and patient-reported outcomes, including shared decision making, care planning, and symptom control. The group also prioritized certain safety and structural measures to complement condition-specific process measures. Further, the group explored strategies for using clinical pathways and devising layered measurement approaches to improve measurement for accountable care."

According to the news reporters, the research concluded: "This article presents the roundtable's conclusions and recommendations for next steps."

For more information on this research see: Improving Oncology Quality Measurement in Accountable Care: Filling Gaps with Cross-Cutting Measures. Journal of Managed Care & Specialty Pharmacy, 2017;23(2):148-155. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

Our news journalists report that additional information may be obtained by contacting T. Valuck, Discern Hlth, Baltimore, MD 21201, United States. Additional authors for this research include D. Blaisdell, D.P. Dugan, K. Westrich, R.W. Dubois, R.S. Miller and M. McClellan.

Keywords for this news article include: Baltimore, Maryland, United States, North and Central America, Managed Care, Investment and Finance, Diagnostics and Screening, Oncology, Genetics, Cancer.