Washington, DC (PRWEB) August 06, 2014
Recent results from a UnitedHealthcare oncology-focused bundling pilot have caught the attention of the health insurance industry by demonstrating that the model saves money for more than just procedural care, like knee replacements. For its Aug. 4 issue, Atlantic Information Services, Inc.’s Health Plan Week (HPW) interviewed Lee Newcomer, M.D., a senior vice president at UnitedHealthcare with strategic responsibility for oncology, genetics and women’s health, on the recently released pilot program’s results. The pilot paid doctors upfront for treating cancer patients and showed a 34% cost reduction compared with fee-for-service (FFS) payment. The insurer says this was, to its knowledge, the first trial of a true episode or bundled payment in medical oncology.
“The goal of the program was to disintermediate the relationship between physician income and the drugs they prescribed,” Newcomer told HPW. “In medical oncology, physicians buy these drugs at wholesale, yet they [sell] them [back] to us. In the current environment, that spread funds about 70% of the practice income or profits.” Under the pilot, which covered 810 cancer patients, medical oncologists were reimbursed upfront for an entire treatment program, and examined the difference in cost before and after the payment change. For patients taking part in the study, the total cost of medical care was $64.76 million, a savings of $33.36 million when compared with the control group.
“Our study made it very clear that it is possible to get at the true expense of cancer care,” Newcomer said. “Fewer hospitalizations, which meant fewer problems for patients and decreased drug spend. This challenges the assumption that drug spend influences doctors. We did not find that to be the case at all.”
Newcomer said that UnitedHealthcare plans to restart the pilot program and re-measure the results in a few years.
Visit http://aishealth.com/archive/nhpw080414-02 to read the article in its entirety, which includes analysis and commentary from Francois de Brantes, executive director, Health Care Incentives Improvement Institute, David Muhlestein, Ph.D., director of research for consulting firm Leavitt Partners, LLC, and James Whisler, a principal at Deloitte Consulting and the lead of the firm’s health actuarial practice.
About Health Plan Week
Published since 1991, the 8-page weekly newsletter Health Plan Week provides timely, objective business, financial and regulatory news of the health insurance industry. Coverage includes new benefit designs and underwriting practices, new products and marketing strategies, mergers and alliances, financial performance and results, Medicare and Medicaid opportunities, disease management, and the flood of reform-driven regulatory initiatives including medical loss ratios, exchanges, ACOs and myriad benefit design changes that are mandated. Visit http://aishealth.com/marketplace/health-plan-week for more information.
About Atlantic Information Services
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://AISHealth.com.