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Oncology alternative payment models: lessons from commercial insurance.

Shaughnessy E, Johnson DC, Lyss AJ, Parikh RB, Peskin SR, Polite BN, Royalty JA, Sagar B, Smith E, Goh L. Oncology alternative payment models: lessons from commercial insurance. The American journal of managed care. 2022 Mar 1; 28(3):98-100.

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Abstract:

Many payers and clinicians are committed to advancing value-based care through the establishment of alternative payment models (APMs) that incentivize practices and clinicians to improve quality and reduce cost. A multistakeholder working group has observed that in specialty fields such as oncology, despite many attempts to design and implement APM pilots for commercial and Medicare Advantage populations, practical challenges and small numbers of episodes and patients present headwinds to viability and scalability. Despite this, some payers report emerging good practices and are optimistic about APMs. Careful and realistic consideration of the specific goals of a proposed model is warranted, as is close examination of the feasibility of transferring risk.




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