The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.
“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”
Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”
A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.
“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.
UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com
Mary Lou Salvemini