ASH 2015: A closer look at how we pay for treatment of blood cancers

December 5, 2015 | by Letisia Marquez

The United States spends $2.6 trillion each year on health care – that’s more than the gross domestic product of Russia, Brazil, Italy and Canada, says Joseph Alvarnas, M.D., director of value based analytics at City of Hope. There may be a better way.

Which is why the federal Center for Medicare and Medicaid Innovation is exploring new ways of paying for health care.

Alvarnas discussed one of those ideas, the “episodes of care” payment model, with Managed Healthcare Executive in a preview to an upcoming session at the American Society of Hematology’s annual meeting. He will be a panelist at that session on Sunday, Dec. 6, as the larger ASH conference unfolds in Orlando, Florida.

“Episodes of care payment is a way of trying to realign payment for cancer care around a period of time rather than simply paying for each service in a separate and disconnected way,” Alvarnas said in the interview.

By focusing on a specific period of time, doctors are more likely to be mindful of their decisions, he said.

But Alvarnas cautioned that these payment models raise important issues in hematology.

Blood cancers are diseases that are often very expensive to treat. Effective care of a patient with acute leukemia, lymphoma and myeloma is quite complex.

“As there has been a push by government and payers to control costs, many patients have been restricted to the lowest cost system, rather than the system that provides the most appropriate and effective care,” he said. “As payers become more and more focused on cost, our challenge is to remind them that issues of cost should never be viewed separately from outcomes data.”

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