Assessing the potential revenue impact to oncology practices under a cancer drug therapy bundled reimbursement model
By Stephen George and Stuart D. Rachlin
20 March 2017
This report utilizes a Monte Carlo simulation and patient vignettes to randomly assign patients to oncology practices and compare payments for cancer drug treatments (CDTs) and related professional services under a simple oncology bundled payment to fee-for-service payments for the same services. The purpose is to illustrate potential payment variability across patients. It focuses on two cancer types: stage III colon cancer and non-small cell lung cancer. Although not an illustration of the proposed CMS Oncology Care Model (OCM), the report notes that OCM includes some design features to mitigate the effects of random variation while still aligning quality and reimbursement.
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Assessing the potential revenue impact to oncology practices under a cancer drug therapy bundled reimbursement model
This report evaluates the potential impact to provider reimbursement under alternative oncology payment structures and illustrates the inherent variabilities across patients using a simplified alternative oncology payment bundle for cancer drug treatments and related professional services.
Stephen George, Stuart Rachlin