Bundled payments could be used for breast cancer

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The Harvey L. Neiman Health Policy Institute has proposed a system of bundled payments for breast cancer screening and care.

The proposal, which was published in the Journal of the American College of Radiology, was constructed using both Medicare claims data and information from a healthcare provider. It includes ways to assess risk, criteria for alternative screening episodes, ways to set and calibrate prices. The researchers say the bundle could not only improve screening adherence among patients using such a bundle, it could also be used as a blueprint for bundles for other episodes of cancer care.

“As the U.S. healthcare delivery system transitions from fee-for-service to value-based payments, it’s important that (radiologists) are at the table to ensure that our patients have access to high quality imaging,” said Geraldine McGinty, M.D., vice chair of the American College of Radiology (ACR) Board of Chancellors and a member of the Neiman Institute’s advisory board, in a statement. “Bundled payments are seen by policymakers as a vehicle for aligning incentives and in fact the Centers for Medicare and Medicaid Services have now imposed mandatory bundling for joint replacement and cardiovascular care.”

Cancer care is among the costliest forms of healthcare delivery. Patients who have battled the disease often are left with huge mountains of debt, even if they have insurance. That is not to mention the bills they may have for years or decades afterward for followup screenings and care. Moreover, the wasteful use of cancer drugs costs the insurance industry at least $3 billion a year.

“In an effort to curb healthcare costs and improve the quality of care, bundled payment models are becoming increasingly adopted,” said Danny R. Hughes, a Neiman Institute senior director for health policy research and senior research fellow, in a statement. “To date, these models have focused primarily on treatment episodes and primary care providers. To achieve current Medicare goals of transitioning fee-for-service payments to alternative payment models, a broader range of patient episodes and specialty physicians will need opportunities to participate.”

– read the study abstract
– check out the statement