Texas Oncology's vice president of payer and public health strategy/relations, Travis Brewer, has outlined a comprehensive approach to implementing successful value-based care models in oncology, emphasizing that quality care and cost efficiency can be achieved simultaneously.
"I don't see it so much as a balance," Brewer explains. "The question implies you have to give up one to get the other, and I don't believe that's the case." This perspective challenges the common assumption that cost containment necessarily compromises care quality in oncology settings.
Integrated Care Model Benefits
The cornerstone of effective value-based oncology care lies in comprehensive multidisciplinary teams. Brewer emphasizes that bringing multiple services under one roof significantly enhances patient care delivery and outcomes. The integrated approach includes:
- Nutritional counseling services
- Social work support
- Financial toxicity management
- Integrated pharmacy operations
"The more holistically you can approach the care of the patients that we treat... the better patient experience you're going to have overall," Brewer states. The integration of pharmacy services has proven particularly valuable, improving medication adherence while reducing waste in oral medication management.
Payment Model Evolution
While discussing emerging payment structures, Brewer offers critical insights into the challenges and opportunities of various reimbursement models. He notes that many value-based care models initially show promise but often struggle to maintain effectiveness due to oncology's inherent complexity.
"Oncology care is complex," Brewer emphasizes. "It's very difficult to wrap a single value-based care model around something as complex as oncology." He advocates for a more targeted approach, particularly when implementing bundled or capitated payment models.
Adapting to Innovation
The rapidly evolving nature of cancer treatment presents unique challenges for value-based care models. New therapeutic options consistently emerge, potentially disrupting established payment frameworks. Brewer notes that capitation models are particularly vulnerable to these changes: "As soon as you put a capitation model in place, it almost immediately begins to leak, because of all the new things that were not contemplated."
To address these challenges, Brewer recommends:
- Starting with specific, manageable disease types
- Building programs gradually
- Maintaining flexibility to accommodate therapeutic advances
- Regular model reassessment and adjustment
This measured approach allows organizations to develop effective value-based programs while ensuring sustainable, high-quality patient care in an evolving treatment landscape.
