Oncology Care Model
Fellowship Year 2015-2016
Cancer Care 2.0: Better Outcomes, Better Value
The cost of cancer care is high and rising. National expenditures for cancer were $125 billion in 2010 and are estimated to rise to as high as $206 billion in 2020.
The root of the problem? Physician choice of therapies is a principal cost driver, with as much as a three-fold variation in the use of costly drugs, tests, and procedures without any associated clinical benefit to patients.
The current adult cancer care model—in which highly trained physicians tailor solutions for each patient—is poorly suited to increasing treatment complexity, rising cancer rates, looming physician shortages, and rapidly shifting payment models that leave health systems bearing financial consequences of unwarranted clinical variation. Facing these challenges, our team sought to identify a higher-value method of delivering cancer care to reduce spending and improve outcomes for cancer patients.
CERC’s Cancer 2.0 team focused on redesigning oncology care through three mutually reinforcing solutions:
· The use of pathways software to select high- value tests and treatments for patients at the point of care.
· The use of a physician innovation collaborative to ensure pathways-consistent care across the care cycle, engage in regular meetings to assess the performance of the pathways, and assure continuing clinician engagement.
· The use of lower-cost nurse practitioners and physician assistants to deliver care for the approximately 60 percent of cancer patients whose care plans are formulaic and predictable.
Conservative forecasts show that CERC’s Cancer 2.0 model could result in a net reduction in per-capita spending for cancer care by 21%. If scaled nationally, this would be equivalent to approximately $32 billion in 2015.
Team: Ian Goldstein MD, MPH, Julie Kuznetsov, MBA, Adam Miner, PsyD, Doug Blayney, MD, Sierra Matula, MD, Terry Platchek, MD, Arnie Milstein, MD, MPH, Manali Patel, MD