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An Analysis of Current Value-Based Payment Frameworks applied in Oncology: A Payer Perspective

Benkovszky, Justin (2020) An Analysis of Current Value-Based Payment Frameworks applied in Oncology: A Payer Perspective. Master Essay, University of Pittsburgh.

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Abstract

In the United States, cancer remains one of the leading causes of death, as well as one of the most expensive conditions, across all medical domains. In efforts to address this public health concern, health systems are implementing new payment structures to improve quality and lower the cost for cancer services. The number of Value Based Programs (VBPs) and Alternative Payment Models (APM)s continue to grow, despite numerous challenges discussed in literature and industry. Under the umbrella of CMS, The Health Care Plan Learning Action Network (HCPLAN) regulates and measures the number of payer and provider contracts tied to various quality measures, but the question of whether or not APMs improve clinical value through a reduction of cost and improved patient outcomes remains unanswered. This paper explores the complexity of APM adoption within the realm of oncology and highlights additional challenges that health systems potentially face when considering payment implementation. The findings of the paper suggest that the need for clear definitions of cancer care, patient populations, strong data reporting capabilities, and scope of APM adoption are paramount before implementation.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Benkovszky, Justinjpf45@pitt.edujpf45
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairSabik, Lindsaylsabik@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee Co-ChairSlivka, Williamwaslivka@katz.pitt.eduUNSPECIFIEDUNSPECIFIED
Date: April 2020
Date Type: Completion
Number of Pages: 43
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Health Policy & Management
Degree: MHA - Master of Health Administration
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 25 Aug 2020 14:10
Last Modified: 25 Aug 2020 14:10
URI: http://d-scholarship.pitt.edu/id/eprint/38864

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