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Alternative payment and care‐delivery models in oncology: A systematic review
Authors:Emeline M. Aviki MD  MBA  Stephen M. Schleicher MD  MBA  Samyukta Mullangi MD  MBA  Konstantina Matsoukas MLIS  Deborah Korenstein MD
Affiliation:1. Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, New York;2. Division of Gynecologic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York;3. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York;4. Department of Medicine, Michigan Medicine, Ann Arbor, Michigan;5. Library Services, Memorial Sloan Kettering Cancer Center, New York, New York
Abstract:Rising US health care costs have led to the creation of alternative payment and care‐delivery models designed to maximize outcomes and/or minimize costs through changes in reimbursement and care delivery. The impact of these interventions in cancer care is unclear. This review was undertaken to describe the landscape of new alternative payment and care‐delivery models in cancer care. In this systematic review, 22 alternative payment and/or care‐delivery models in cancer care were identified. These included 6 bundled payments, 4 accountable care organizations, 9 patient‐centered medical homes, and 3 other interventions. Only 12 interventions reported outcomes; the majority (n = 7; 58%) improved value, 4 had no impact, and 1 reduced value, but only initially. Heterogeneity of outcomes precluded a meta‐analysis. Despite the growth in alternative payment and delivery models in cancer, there is limited evidence to evaluate their efficacy. Cancer 2018. © 2018 American Cancer Society.
Keywords:Affordable Care Act  alternative care delivery models  alternative payment models  cancer  cancer delivery  health care delivery  value‐based cancer care  value‐based health care delivery  value‐based payment models
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