November 2020 Edition Vol.12, Issue 11

Four Oncology Payment Reform Briefs




Oncology Care Model 2.0 Preview

An expert panel at the recent COA Payer Exchange Summit discussed the OCM 2.0 payment reform model, a pilot that COA will launch in early 2021. Catch a preview of the OCM 2.0 on the road to meaningful reform in cancer care delivery.



Three Payment Reform Projects

Stakeholders are experimenting with oncology payment models at the local, state and national levels. Take a deep dive into three ongoing payment reform projects initiated by Michiana Hem-Onc, BCBS Michigan and Cigna Health Care. Find out how they got off the ground and how they’re evolving to keep cancer costs down and quality of care high.



The Impact of Insurer Mandates

While strategies to keep costs down such as “white bagging”, step therapy and home infusion may benefit payers and PBMs, such mandates give oncology providers less control over their patients’ healthcare and ultimately cancer patients may suffer. At the COA Payer Exchange Summit, experts assessed the potentially negative impact of these and other payer strategies.



PBMs: Friend or Foe?

PBMs are intended to add value to the healthcare system. But in reality the industry poses conflicts of interest that may result in contentious issues for oncology providers in terms of rebates, spread pricing and patient access. COA panelists discussed efforts to circumvent what seems to be a powerful marketplace force.



For an interactive map of models and additional details, visit:

Image Credit:  2020 Community Oncology Alliance Payment Reform Brief











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