Positioning for Value-Based Cancer Care: Lessons and Opportunities

The past 20 years have brought tremendous progress in cancer outcomes with improved screening and new treatments. But with these innovations and our country’s aging population, escalating care costs and quality variation continue to confound the system. As public and private payers seek a framework for high-quality, equitable and affordable cancer treatment in the future, efforts to pursue value-based approaches have occurred in a halting fashion, creating a challenging environment for providers and payers to navigate.

In late June 2022, the Centers for Medicare & Medicaid Services’ (CMS) Innovation Center launched the Enhancing Oncology Model (EOM), an alternative payment model seeking to incentivize providers in oncology practices to provide “whole-person care,” including screenings for health-related social needs, services to help patients navigate their cancer care needs, care planning, soliciting patient-reported outcomes data, and other activities that promote health equity. This new model affirms CMS’s commitment to pursuing value in cancer care and reinforces the need for providers to continue to implement value-based care programs.

In a new white paper, “Positioning for Value-Based Cancer Care: Lessons and Opportunities for Health Systems and Oncology Service Lines,” Manatt Health explains the EOM and provides strategies oncology providers can develop now to prepare for a reimbursement system that is shifting toward value-based cancer care. The paper also describes examples of how CMS, commercial payers and employers are seeking to advance alternative payment models for cancer care.

To read the full white paper, click here.

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