Alternative Payment Models (APMs) in Oncology
“Value-based care” infers a cost consciousness: assuming responsibility for and taking action to avoid unnecessary, unwarranted medical services that inflate the costs of care. Coupled with this notion of value-based care is the goal to pay differently than traditional fee-for service for the value of the care. “Paying differently has become known as “alternative payment.”
We are expert in the emerging Alternative Payment Models (APMs) in oncology: the oncology Care Model (OCM) program, oncology medical home shared savings models and in commercial bundled pricing for episodes of care. We design, develop, negotiate and implement alternative payment programs between oncology providers and payors.
Particular areas of expertise include:
· OCM advisory, advocacy, performance-based payment reconciliation and assumption of 2-sided risk
We are a regular contributor to the OCM Collaborative of the Association of Community Cancer Centers (ACCC). We encourage all OCM Participants to enroll and participate in this invaluable OCM problem-solving and learning network
· Gainshare contract evaluation and re-negotiation
· Self-insured employer/payor facing initiatives
· Global budget planning and analysis and bundled pricing model design, actuarial analysis, pricing structures, performance tracking and payment reconciliation
· Data analytics, actuarial and predictive modeling capabilities are provided through strategic affiliation with the healthcare analytics and bundled pricing firm, Archway Health.