Program Serves as Model for Future Oncology Medical Home Programs
NASHVILLE – Tennessee Oncology and BlueCross BlueShield of Tennessee (BlueCross) recently kicked off an innovative value-based cancer care program to improve treatment coordination for thousands of Tennesseans. This venture launched earlier this month for BlueCross networks P, S, and L and will be one of the most comprehensive value-based arrangements for cancer care in the country.
As a value-based initiative, the program is designed to support high-quality, cost-effective health care for patients. The initiative follows BlueCross members at all phases of the cancer journey from diagnosis through treatment and follow-up, and providers earn financial incentives or penalties based on how well members’ care is coordinated and documented. BlueCross and Tennessee Oncology will:
- ensure best practices are followed in care planning and treatment,
- analyze treatment data to make sure care guidelines are met and patients receive the right treatment at the right time, and
- provide patient-centered care throughout the process.
As the clinical partner in the Oncology Medical Home, Tennessee Oncology will maintain key quality designations including the Quality Oncology Practice Initiative (QOPI) Certification awarded by the American Society of Clinical Oncology (ASCO).
According to the American Cancer Society, there will be nearly 42,000 new cancer diagnoses in Tennessee in 2021 – and it’s no secret that the cost of treating the disease can be significant. Roughly 18,000 BlueCross members diagnosed with cancer undergo chemotherapy every year, with average claims of $75,000 for six months of treatment. Addressing those costs can help members and employer customers save on care.
“This program supports our members’ peace of mind by enabling access to the highest-quality, patient-centered care for their condition,” said Dr. Andrea Willis, senior vice president and chief clinical officer for BlueCross BlueShield of Tennessee.
“The prevalence and cost of cancer care makes this initiative extremely valuable to our members and employer customers,” said Todd Ray, SVP, corporate provider network management and Medicare products for BlueCross. “Tennessee Oncology’s commitment to demonstrating quality and value for our members, and their investment in the data analytics capabilities needed to support this type of program, have made them a great collaborator in advancing these objectives.”
The program was developed through a comprehensive evaluation of the most effective features of other value-based cancer care programs in recent years, including the Oncology Care Model overseen by the Centers for Medicare and Medicaid Innovation. The program also set a high bar for the data and technology infrastructure needed to support quality care throughout a patient’s cancer care journey.
“Our commitment to innovation and patient-centered care have always been core to the culture of Tennessee Oncology,” said Natalie Dickson, MD, president of Tennessee Oncology. “The current era of personalized medicine is especially encouraging for our patients and clinicians; however, affordability will continue to be a major challenge. As evidenced by this program, the role of the health plans is becoming increasingly important to enable us to fulfill our mission. This value-based care initiative will serve as a model for how clinicians and health insurers can collaborate to benefit patients.”
BlueCross BlueShield of Tennessee is a taxpaying, not-for-profit health plan serving more than 3.4 million members in Tennessee and around the country. The Chattanooga-based company was founded in 1945 and has brought peace of mind to its members and local communities for more than 75 years. BlueCross BlueShield of Tennessee Inc. is an independent licensee of the BlueCross BlueShield Association. For more information, visit the company’s news center at bcbstnews.com.
About Tennessee Oncology
Tennessee Oncology is one of the most comprehensive community oncology practices in the nation with over 194 cancer care providers serving 33 centers across Middle Tennessee and North Georgia. Tennessee Oncology is a partner practice of OneOncology, the national platform for independent oncology practices.