As most readers of this blog know, one of the issues we've been tracking the most carefully these past few months is novel payment methodologies for cancer services. Because oncology is not a focus of any of the new Medicare pilots (bundling, etc) the concept has been slower to take off. The early focus of new models has been on chemotherapy and innovators there include United and some of the pathways providers, such as Innovent, Via Oncology and P4. But we just came across a new idea which we wanted to share.
Cancer Treatment Centers of America (CTCA) has just announced a plan to create a "fixed-price protocol" for the diagnosis and care planning process. CTCA has identified a need to streamline this process, which they state can take as long as 2 to 3 months. They are going to offer a comprehensive process that will be guaranteed to take place in no more than 5 days at a fixed price, focusing specifically on the major tumor sites - prostate, breast, lung and colorectal. Prices will be preset by tumor site and will range from $10,000 for prostate to $14,200 for breast. They plan to roll them out across the next 2 months, and if successful, will expand to less common tumor sites.
CTCA to offer diagnosis and treatment plan as a bundle
For some reason, we've seen a big spike this week in questions about mid-level providers. Given that this is such a hot topic, I thought it might be helpful to post some excerpts from the discussions that my colleagues and I have been having.
You'll see that we don't have all of the answers so I would love to hear from you. How does your organization use NPs and PAs? How do you manage compensation? recruitment? retention? Are physicians compensated for supervising mid-levels? Please submit your comments and questions by completing the form at the bottom of this post.
How do other hospitals structure mid-level providers' compensation?
Based on my conversations with Roundtable members, most MLPs are salaried, and in some cases, they may be eligible for performance bonuses based on quality and/or productivity. However, given the breadth of MLPs' responsibilities, it can be difficult to develop adequate performance metrics.
FAQs about mid-level providers in oncology practice
A new study from researchers at the University of Michigan finds that women with breast cancer were better able to make decisions about their treatment when presented with a series of simple choices rather than one complex decision.
Researchers divided the women into two groups. The first group was asked to choose between four or more treatment options representing different combinations of hormonal therapy and chemotherapy. They found that women in this group opted for chemotherapy regardless of whether the benefit was 1% or 5%.
The second group was presented with the same treatment options, but they were asked to make two separate decisions. First, they were asked to decide whether or not to take hormonal therapy. If they opted to, then they were asked whether or not to undergo chemotherapy. A larger proportion of these women opted for chemotherapy only if it provided a significant benefit.
Treatment decisions improve when presented as a series of choices