Bundled Payment Models for Cancer-Related Costs

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Cancer medication is expensive and complicated to deliver, which contributes to the rapid rise of healthcare costs, explains Andrew L. Pecora, MD, FACP, CPE. In response to this exponential growth, he says, payers have started to implement a bundled payment design. In this model, wasting resources on unnecessary care is avoided without depriving the patient of needed care.

The Oncology Care Model, initiated by the Center for Medicare & Medicaid Innovation office of the Centers for Medicare & Medicaid Services, is one approach being tested. Cigna, Regional Cancer Care Associates, and UnitedHealthcare, are piloting approaches to rein in costs through incentives and other strategies, adds Pecora. Implementing these strategies comes with challenges, such as shifting the focus from cutting costs to improving quality, he says.