ICYMI: Highlights From COA 2024

At this year’s meetings of the Community Oncology Alliance (COA), panelists addressed key challenges in oncology care, including the impact of the end of the Oncology Care Model (OCM), drug price negotiations under the Inflation Reduction Act (IRA), and more.

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Here are the top 5 COA content items in 2024; access all our COA coverage here.

5. End of OCM Brings Drop-Off in Value-Based Care Volume, and New Questions

The end of the OCM has led to significant reductions in value-based care volumes, with financial shifts prompting challenges in sustaining extended patient services and equitable care delivery. During the COA conference, experts, including Stephen “Fred” Divers, MD, of Genesis Cancer & Blood Institute, who is chief medical officer of American Oncology Network, highlighted the importance of partnerships with primary care providers, the complexities of managing risk-bearing models, and the need for robust data systems to improve patient outcomes. Panelists emphasized the critical role of multidisciplinary collaboration and innovative solutions, such as artificial intelligence, in navigating the evolving oncology landscape.

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4. IRA Negotiated Drug Prices Can’t Come “On the Backs of Providers”

The IRA’s drug price negotiations have raised concerns about significant reimbursement cuts for oncology providers, potentially as high as 49%, according to Nick Ferreyros, managing director of COA. As subsequent rounds of negotiations expand to include more drugs, COA plans to intensify advocacy efforts, urging Congress to implement technical fixes to prevent unintended financial consequences that could harm community oncology practices. The organization emphasized the need to protect providers while achieving the IRA’s goal of reducing drug costs for taxpayers.

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3. Scaling Value-Based Care: Addressing Systemic Issues With Innovative Payer-Provider Collaboration

At the COA Payer Exchange Summit, panelists emphasized that strong collaboration between payers and providers is essential for developing value-based care models that enhance patient outcomes while addressing stakeholder concerns. Strategies discussed included trust-building, simplifying quality metrics, and aligning goals early to avoid burnout and inefficiencies. Programs like UnitedHealthcare's episodes of care and Humana’s oncology models highlighted the need for innovative, scalable solutions and open communication to balance cost management with quality care delivery.

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2. Navigating the Community Oncology Relationship With the Local Hospital

Panelists discussed the evolving dynamics between independent oncology practices and hospitals, highlighting challenges such as resource disparities, 340B incentives, and competitive tactics. While some practices, like Alliance Cancer Specialists, faced adversarial actions leading to legal battles, others reported productive collaborations. Panelists emphasized the importance of community support, quality care metrics, and strategic partnerships to ensure the success of independent practices in an increasingly hospital-dominated landscape.

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1. Rethinking the Role of PBMs in Health Care Reform

Panelists at the COA Payer Exchange Summit emphasized the need for transparency and policy changes to reform the pharmacy benefit manager (PBM) market, including banning spread pricing and addressing rebate schemes that suppress biosimilar adoption. The experts showcased transparent PBM models prioritizing patient benefits and cost reduction, while highlighting challenges such as administrative burdens for employers and the entrenched complexity of the PBM system. The discussion underscored the urgency for legislative action to realign financial incentives and ensure health care resources directly benefit patients and providers.

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