Cancer care suffers from many of the well-known flaws in the American health care delivery system. Most of the care delivery shortfalls and inefficiencies can be tied, in part, back to payment systems that support high-cost procedures rather than focusing on assisting providers in improving the outcomes of individual patients and the value of care being delivered. We describe various new models of physician payment that can serve as a foundation for a shift away from the current reimbursement system for cancer care to support better outcomes and avoid preventable costs. These recent payment reforms include the implementation of clinical pathways, bundled or episodic payments, payments tied to quality improvements, and the patient-centered oncology medical home. We then describe how these reforms can be supported in a blended payment model that transitions away from, but still contains elements of, fee-for-service payments.
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