Pathways, Oncology APMs, Medical Homes Key to Improving Quality of Care, ASCO Tells Congress

March 19, 2019

ASCO recently submitted comments in response to a request for information (RFI) from the Chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee. The RFI sought specific ideas on reducing health care costs from providers, insurers, and other stakeholders. ASCO's comments urge Congress to work with the Administration to: 

  • Promote value-based incentives for improving the quality of care and lowering health care costs
  • Encourage adoption of high-quality clinical pathways
  • Work with the Center for Medicare and Medicaid Innovation (CMMI) to perform small-scale testing of—and ultimately approve—multiple oncology-focused Alternative Payment Models (APMs)
  • Test and adopt ASCO’s APM, the Patient-Centered Oncology Payment Model (PCOP)
  • Designate certain oncology practices as medical homes with provisions for expanded reimbursement for providing coordinated care
  • Reduce the administrative burden of utilization management practices such as prior authorization and step therapy, which can be harmful to patients

“ASCO urges Congress to work with CMS and other payers to streamline the prior authorization process and create a standardized system that reduces burden on oncologists and patients with cancer,” said ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, in the comments. “One important step to accomplish this is passage of the Restoring the Patient’s Voices Act (H.R. 2077 in the 115th Congress).”

The RFI was issued following a series of Senate HELP Committee hearings in 2018 focused on the rising cost of health care, and ASCO’s response was submitted as numerous Congressional committees continue to work on the issue.

Read the full comment letter.

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