Dr John Fox: The Oncology Medical Home Model Can Decrease Costs

The key to driving down costs, or at the very least making costs more predictable, is integrating pathways into the Oncology Care Model program, said John L. Fox, MD, MS, associate vice president of medical affairs at Priority Health.

Transcript (slightly modified)

Can we draw parallels between payer-driven clinical pathways and the Oncology Medical Home model?

Medicare's Oncology Care Model, which I’m not an expert on, I think has a potential to drive down the cost of healthcare without impacting patient outcomes. There are a number of ways that can happen. One is that the cost of care will become more predictable because the regimens that providers use will have a more predictable cost.

In our experience with our Oncology Medical Home Initiative, where we ask providers to develop pathways around high-volume conditions and not only pathways but preferred regimens, we very clearly showed that providers tended to choose the less costly regimens. So I think that integration of pathways into an oncology care model program is not only essential, but that’s what will help drive down costs, at least make costs more predictable.

But more importantly, I think the pathways have to include or embed advanced care planning. The trends for increasing costs of drugs don’t suggest that will drive down the costs of care simply by having pathways. But if those pathways include discussions of patient preferences and goals of care, then I think it increases the likelihood that will diminish the amount of chemotherapy we’ll give to patients at the end-of-life because they’ll have said, my goals can be obtained in ways other than chemotherapy.