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 The initiative by the Centers for Medicare & Medicaid Services (CMS)
as part of the Affordable Care Act, often referred to as Obamacare,
comes as expensive new cancer treatments put an increasing strain on
state and federal healthcare budgets.
"We aim to provide Medicare beneficiaries struggling with cancer
with high-quality care around the clock and to reward doctors for
the value, not volume, of care they provide," Dr. Patrick Conway,
the chief medical officer for CMS, said in a statement.
Cancer cost the United States an estimated $263.8 billion in medical
costs and lost productivity in 2010, according to the National
Institutes of Health. The majority of those diagnosed are over 65
and Medicare beneficiaries, CMS said.
CMS said it has determined that a new way of paying for and
delivering cancer care is needed. Called the Oncology Care Model, it
would invest in physician-led practices.
The initiative aims to link payment to quality of care, find new
ways to improve and coordinate care delivery, and to share cancer
care information more broadly among providers, consumers, and others
to support better decisions, CMS said.
It said the model would reward practices that focus on providing
services that specifically improve the patient experience and health
outcomes, the agency said.
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CMS hopes to broaden the initiative to include a larger portion of
the population through participation of Medicaid programs and
non-government payers.
Physician group practices and solo practitioners that provide
chemotherapy for cancer and are enrolled in Medicare may apply to
participate, CMS said.
"Other payers, including commercial insurers, Medicare Advantage
plans, state programs, and Medicaid managed care plans, are also
encouraged to apply," it said.
(Reporting by Bill Berkrot; Editing by Grant McCool)
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