Understanding and Surviving the Transition to Value-Based Oncology

Abstract

 Figures Driven by economic, social, and moral imperatives, our society has to reckon with the unsustainable growth of health care spending and inappropriate variations in access to and definitions of quality health care. Health expenditures in the United States neared $2.6 trillion in 2010, over 10 times the $256 billion spent in 1980. 1 In total, health spending accounted for 17.9% of the nation's gross domestic product (GDP) in 2010 and will account for one-fifth of our GDP by the end of this decade, potentially consuming our entire GDP by midcentury. 2 Cancer care accounts for one of the fastest growing segments in health care spending. Health care purchasers are focused on reigning in their health care costs— be they private insurers, large employers, or the government (which now accounts for over one-half of all health care expenditures). All purchasers demand cost control while making sure the monies they are spending are purchasing high-quality, predictable care. Ongoing themes include reducing prices per unit of care delivered, reducing the volume of services consumed per individual, and increasing access and quality of care. Levers are in play to accomplish these goals. Large payers are qualifying narrower networks of providers based on cost and measures of quality and then using the payers' clout to steer patients into those networks. To