New Compensation Approach for Cancer Care Using Pay for Performance Model Advocated Today in Lead Article in Cancer Journal Oncology Issues: Los Angeles-based Aptium Oncology outlines novel strategy for policy makers as healthcare industry grapples with pay for performance compensation structure for oncology services Oncology represents the last frontier for pay for performance advocates

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A novel strategy to pay for the costs of cancer care using a pay for performance compensation model, is profiled today in the lead article of the March/April edition of Oncology Issues, the journal of the Association of Community Cancer Centers.

We are convinced P4P can uphold and even enhance the vision of ongoing quality improvement and cost efficiency in patient care and contribute to enhanced patient satisfaction

    The article, entitled "Quality Care, Outcome and Cost...a Complex Balance," was authored by John S. Macdonald, MD, chief medical officer for Aptium Oncology, and Deane Wolcott, MD, Aptium's vice president, clinical program development. Los Angeles-based Aptium Oncology is the national leader in developing and managing comprehensive cancer centers at premier medical institutions throughout the United States.

"Until recently, the sheer complexities of cancer care have inoculated us from oncology-specific pay for performance compensation structures," says Dr. Macdonald. "The diagnosis and treatment of the 130 to 150 diseases defined as cancer present enormous challenges and don't fit P4P guidelines applied to most other medical specialties. But we recognize the day is approaching when P4P could be mandated, so we believe it is critical to step out in front and help policy makers formulate the compensation guidelines."

The authors acknowledge the fears of P4P skeptics and opponents, who doubt that performance measures can be developed without resulting in inappropriate therapies and restricting clinical judgment.

"The rapid changes in cancer care create a unique challenge for oncologists," says Dr. Wolcott. "They are acutely aware that it's not what they already know but what they will learn next that raises the bar and sets the standard of care.

"That's why measures in any P4P model have to updated constantly to ensure that oncologists transform the latest advancements and insights into improved patient care."

Another key component that must be considered as part of a successful P4P model is physician buy-in. The article notes the struggle faced in communities where P4P applications failed to account for the expectations of patients and the value placed on physician/patient interaction.

"In the final analysis, a successful P4P model has to measure the delivery of quality cancer care that is as comprehensive as it is compassionate," says Dr. Macdonald. ""Reporting systems should be tailored to augment, rather than over burden, patient care, keeping in mind that kindness, compassion, comfort and convenience are the salient characteristics of care.

"We already know from the experience of physicians in other specialties about 'the burden of reporting' and a sense that 'P4P means a little more money and a lot more work.'"

The authors believe that oncology P4P metrics should be developed through a collaboration of stakeholders representing a cross-section of oncology service providers, as well as payers, employers, cancer survivor groups, the Centers for Medicare and Medicaid Services (CMS) and organizations that have worked with CMS in developing other P4P programs.

"We are convinced P4P can uphold and even enhance the vision of ongoing quality improvement and cost efficiency in patient care and contribute to enhanced patient satisfaction," says Dr. Wolcott. "A phased-in approach will help ensure this vision, focusing on a small number of quality measures for key cancer services and giving everyone ample opportunity to adapt.

"Once success has been achieved preliminarily, additional measures can be added in increments, ensuring that quality management resources will not be overwhelmed."

About Aptium Oncology

Aptium Oncology has more than 20 years of experience managing outpatient oncology services at leading medical institutions throughout the United States. Aptium Oncology is a pioneer in designing, building and managing comprehensive cancer centers with a steadfast vision to transform cancer care environments by bringing every necessary service to one central place. The intent of this single place is to help patients achieve longer, better lives. Aptium Oncology's corporate headquarters is located in Los Angeles, Calif.

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