Regulations

New ACA Program Rewards Value of Care, not Volume

By Robert Sheen | February 13, 2015

Doctors treating cancer patients will be paid based the the they deliver rather than the volume services they provide, under a new Act announced by the Department and Human Services (HHS) Feb. 12.

HHS said the new multi-payer and delivery model is aimed at improving the quality patients receive, spending dollars more wisely, and contributing to healthier communities.

The initiative will include giving patients undergoing treatment 24- access to practitioners.

Each year more than 1.6 million Americans are diagnosed with cancer. The financial in 2010 was estimated at estimated $263.8 billion in medical costs and lost productivity.  The majority those diagnosed are beneficiaries over 65 years old.

The , called the Oncology Model, is one a number innovative and delivery models developed by the Centers for & Services (CMS) with input from physicians, patients and the private sector.

CMS is in discussions with commercial insurers, Advantage , state programs, and managed about adopting the model.

HHS said the Oncology Model aims to improve and lower costs through performance-based payments that financially incentivize -quality, coordinated .

Physicians will also receive management payments for each fee-for- beneficiary to support delivery comprehensive, coordinated patient .

The introduction the new model for cancer payments comes about two after HHS Secretary Silvia Burwell announced a goal tying % traditional, or fee-for-, payments to quality or through alternative models by the end 2016, and 50% by the end 2018.

For hospitals, HHS also set a goal tying 85% all traditional payments to quality or by 2016 and % by 2018. These are the first explicit goals HHS has set for alternative models and -based payments.

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