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ASCO 患者为中心的肿瘤学支付模式更新。

Updates to the ASCO Patient-Centered Oncology Payment Model.

机构信息

Swedish Cancer Institute, Edmonds, WA.

American Society of Clinical Oncology, Alexandria, VA.

出版信息

JCO Oncol Pract. 2020 May;16(5):263-269. doi: 10.1200/JOP.19.00776. Epub 2020 Apr 17.

DOI:10.1200/JOP.19.00776
PMID:32302272
Abstract

The past decade has seen considerable innovation in the delivery of care and payment in oncology. Key initiatives have included the development of oncology medical home care delivery standards, the Medicare Oncology Care Model, and multiple commercial payer initiatives. Looking forward, our next challenge is to reflect on lessons learned from these limited-scale demonstration projects and work toward models that are scalable and sustainable and reflect true collaboration between payers and providers sharing common objectives and methods to advance cancer care delivery. To this end, ASCO continues its work on care delivery standards, quality measurement, and alternative payment models. Over the past year, ASCO has received input from physicians, administrators, payers, and employers to update its Patient-Centered Oncology Payment (PCOP) model. PCOP incorporates current work on provider-payer collaboration, the oncology medical home, and the value of clinical pathways and recognizes the need for common quality measurement, performance methodology, and payment structure across multiple sources of payment. The following represents a summary of the entire model. The model includes chapters on PCOP communities, clinical practice transformation, payment methodology, consolidated payments for oncology care, performance methodology, and implementation considerations. In future work, ASCO will continue its support of the PCOP model, including further development of care delivery standards, quality measures, and technology solutions (eg, CancerLinQ).

摘要

过去十年,肿瘤学领域在护理和支付方式方面有了相当大的创新。主要举措包括制定肿瘤医学家庭护理交付标准、医疗保险肿瘤护理模式以及多项商业支付方举措。展望未来,我们的下一个挑战是反思这些有限规模的示范项目中吸取的经验教训,并努力建立可扩展且可持续的模式,反映支付方和提供者之间真正的合作,共同目标和方法来推进癌症护理的提供。为此,ASCO 继续致力于护理交付标准、质量衡量和替代支付模式。在过去的一年中,ASCO 从医生、管理人员、支付方和雇主那里获得了反馈,以更新其以患者为中心的肿瘤支付(PCOP)模型。PCOP 纳入了目前关于提供者-支付方合作、肿瘤医学之家以及临床路径价值的工作,并认识到需要在多个支付来源中使用通用的质量衡量、绩效方法和支付结构。以下是整个模型的摘要。该模型包括 PCOP 社区、临床实践转型、支付方法、肿瘤护理的综合支付、绩效方法和实施注意事项等章节。在未来的工作中,ASCO 将继续支持 PCOP 模型,包括进一步制定护理交付标准、质量措施和技术解决方案(例如,CancerLinQ)。

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Updates to the ASCO Patient-Centered Oncology Payment Model.ASCO 患者为中心的肿瘤学支付模式更新。
JCO Oncol Pract. 2020 May;16(5):263-269. doi: 10.1200/JOP.19.00776. Epub 2020 Apr 17.
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Simulated Costs of the ASCO Patient-Centered Oncology Payment Model in Medicare Beneficiaries With Newly Diagnosed Advanced Ovarian Cancer.模拟 ASCO 以患者为中心的肿瘤支付模式在 Medicare 受益人群中诊断为新发晚期卵巢癌的成本。
J Oncol Pract. 2019 Dec;15(12):e1018-e1027. doi: 10.1200/JOP.19.00026. Epub 2019 Oct 15.
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Design Challenges of an Episode-Based Payment Model in Oncology: The Centers for Medicare & Medicaid Services Oncology Care Model.肿瘤学中基于诊疗阶段付费模式的设计挑战:医疗保险与医疗补助服务中心肿瘤护理模式
J Oncol Pract. 2017 Jul;13(7):e632-e645. doi: 10.1200/JOP.2016.015834. Epub 2017 May 23.
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Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology.支付改革:对妇科肿瘤学产生的前所未有的且不断演变的影响
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States Encouraging Value-Based Payment: Lessons From CMS's State Innovation Models Initiative.鼓励基于价值的支付的州:CMS 的州创新模式倡议的经验教训。
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The patient-centered medical home in oncology: from concept to reality.肿瘤学中的以患者为中心的医疗之家:从概念到现实。
Am Soc Clin Oncol Educ Book. 2015:e82-9. doi: 10.14694/EdBook_AM.2015.35.e82.
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Building Sustainable Practice Transformation Through Payment Reform Initiatives.通过支付改革举措构建可持续的实践转型。
JCO Oncol Pract. 2022 May;18(5):e731-e739. doi: 10.1200/OP.21.00560. Epub 2022 Jan 7.
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Rapid expansion of new oncology care delivery payment models: results from a payer survey.肿瘤护理新支付模式的快速扩张:支付方调查结果
Am Health Drug Benefits. 2013 Jul;6(5):249-56.

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