New Methodologies Create Value for Patients
Higher Quality Care, Fewer Health Care Expenditures
New Methodologies Create Value for Patients
The economic landscape for oncology is laden with excessive expenditures. Our patient population is highly vulnerable across a range of risk factors – medically, financially, emotionally and beyond. And so, the care being provided to them must be intentional and take their best interests into consideration. For this reason, FCS remains steadfast in our pursuit for new and improved approaches and partnerships which create value for our patients and stakeholders. Specifically, we actively seek out new and innovative opportunities to deliver high value care, at a lower cost to the healthcare ecosystem while also bringing an experience to patients that they deserve.
Whenever we use the buzzword term “value-based care,” we are really referring to the approach in which we create value for our patients. This is not a cookie-cutter model, one size fits all model, but rather a range of bespoke options, programs and partners involved. We work closely with commercial payers, Medicare Advantage, and government payers like Medicare, Medicaid, and VA/Tricare to address the needs of our patient population across the risk continuum.
To date, FCS’ largest, and most successful, undertaking in the value-based care arena was through its involvement in the Centers for Medicare and Medicaid Innovation Center (CMMI) Oncology Care Model, which completed in June 2022. Over the course of the multi-year program, FCS made several modifications to processes and invested in systems and people to positively influence and, in several instances, exceeded the goals set by CMMI and surpassed other participants. The results established FCS as a leader in value-based care and created a $210 million reduction in total health care costs.
During the OCM, FCS created a care coordination program to educate and address patient concerns. We also utilized biosimilar drugs to reduce health care expenditures. Next generation sequencing also played a key role in the later periods of the OCM, which expedited targeted treatment options for genetic mutations identified from test results. Combined, inpatient admissions, observation stays, and ER visits were significantly lower when compared against both oncology practices participating in OCM and all oncology practices.
We learned much from the OCM, which has since served as the launching point for new value-based initiatives with the payer community. Many of our successes have been documented in case studies. Several programs are also well underway, strengthening the breadth of our value-based offerings at FCS, such as the CMS Merit-Based Incentive Payment System (MIPS). Our participation in this program will continue to influence our approach to improving quality of care, reducing costs, promoting interoperability, and instilling improvement activities by addressing quality measures focused on depression, pain management, and hospice integration.
Our involvement in MIPS has also sparked internal care coordination spinoffs that will focus on transitional care coordination and advanced care planning astride our principal care coordination program. These will all fit into a larger, comprehensive Holistic Model of Care that will become the standard of care for all FCS patients.
Much progress has been made at FCS to ensure that our patients benefit from the highest quality of care, and yet, there is much anticipation as future endeavors are already underway. We are committed to innovative therapies, advancing precision oncology, and processes that address our patients’ critical needs. These building blocks will shape the future of Value-based care at FCS.
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