How value-based care and oncology come together in the healthcare ecosystem

In In The News by Barbara Jacoby

By: Erin Dietsche


At the MedCity CONVERGE conference in Philadelphia on July 11, experts from Harvard Business School, payer Highmark and tech company Integra Connect explored how their organizations are approaching the intersection of cancer and value-based care.

The movement away from fee-for-service doesn’t only apply to the healthcare industry at large. It also has implications in the field of cancer care. During a panel at MedCity CONVERGE on July 11, experts outlined the current status of value-based care and where oncology fits in.

It helps to start with a definition of value-based care. Dr. Mahek A. Shah, a senior researcher at Harvard Business School and the moderator of the session, described value as health outcomes over the costs of delivering the outcomes.

Mari Vandenburgh, Highmark‘s director of value-based reimbursement options, said value-based care is the movement toward paying providers for outcomes instead of the volume of services received. She added that the Pittsburgh, Pennsylvania-based payer is working to move the field away from seeing it as an incentive and toward viewing it as the way we pay for healthcare.

“All of our value-based care strategy focuses on evidence-based care,” Vandenburgh said.

She went on to spotlight two value-based care projects Highmark is working on. The first is its True Performance program, which just wrapped up its first year. Vandenburgh said it currently involves 588 contracts and 1,648 practices.

Within the oncology space, the insurer is addressing value-based care through the Highmark Cancer Collaborative, which was launched with the Allegheny Health Network Cancer Institute and the Johns Hopkins Kimmel Cancer Center.

Other healthcare players are approaching the issue differently. Integra Connect is a cloud-based technology company focused on helping healthcare organizations address their value-based care needs. It’s specifically focused on specialty care like cancer.

At CONVERGE, Integra CEO Dr. Charles Saunders discussed what’s working and what’s not working within the oncology value-based care realm. While care navigation, enhanced patient access and care path-based treatment choices are positives for the field, there are a few problems. Accessing EHR data to report it to CMS is burdensome, and numerous technology issues limit progress. For instance, legacy EHRs aren’t sufficient for managing patient populations.

Despite challenges, Saunders and Vandenburgh don’t expect value-based care to disappear anytime soon.

“I don’t think we’re going to retreat on value-based care,” Saunders said. Rather, he believes we’ll continue to see a variety of models (from bundled payments to capitation), which will keep evolving over time.