With so many different oncology alternative payment models (APMs) available, choosing the right ones to participate in might simply mean finding which ones already align with what a practice is doing, said Amy Ellis, chief quality officer at Northwest Medical Specialties.
With so many different oncology alternative payment models (APMs) available, choosing the right ones to participate in might simply mean finding which ones already align with what a practice is doing, said Amy Ellis, chief quality officer at Northwest Medical Specialties.
Transcript
Recently, the Community Oncology Alliance released a report that there are more than 30 oncology-related APMs. How does Northwest Medical Specialties determine which model to participate in?
There's a lot of different APMs out there. And what we really try to do is look at the quality measures that that specific APM is requiring, or that specific payer, and how it aligns with our current programs. We don't want to get into a situation where we have 15 different programs with 15 different quality measure rules and methodologies, because there is a lot of administrative burden that takes place behind the scenes of all of these APMs, whether that be, you know, billing out the MEOS [Monthly Enhanced Oncology Services], or tracking the patients—all of these different things.
So, what we really try to do is find out what's aligned with what we're already doing. And of course, there's some wiggle room. If there's something that's trying to introduce a new measure for us, or maybe has a slightly different methodology, we're open to that. But when you get into a space where you have these completely different models, that means you may need more staff to support those models. I think those are the really the key things that we look at is really alignment between the models.
Targeting the Root of gMG With Inebilizumab: A Q&A With Richard Nowak, MD, MS
June 24th 2025In this interview, Richard J. Nowak, MD, MS, principal investigator of the MINT trial of inebilizumab for generalized myasthenia gravis (gMG), discusses the trial’s key findings, including significant improvements in patient- and physician-assessed outcomes, as well as longer-term implications and future areas of investigation.
Read More
Stuck in Prior Auth Purgatory: The Hidden Costs of Health Care Delays
June 19th 2025Delays, denials, and endless paperwork—prior authorization isn’t just a headache for providers; it’s a barrier for patients who need timely care, explains Colin Banas, MD, MHA, chief medical officer with DrFirst.
Listen
Many Patients Stop GLP-1s Before Reaching Target Dose: Hamlet Gasoyan, PhD
June 19th 2025Discontinuing the weight loss treatment before hitting the recommended maintenance dose contributes to low-value care despite provider follow-up and efforts to manage side effects, says Hamlet Gasoyan, PhD, Cleveland Clinic.
Read More