thursday april 23, 2015 mark e. thompson, m.d. and jeff mortier
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Oncology Payment Reform 101 for Cancer Care
AdvocatesThursday April 23, 2015
Mark E. Thompson, M.D. and Jeff Mortier
WHERE THE DISCUSSIONS ARE BEING HELD
WHERE CARE IS GIVEN!
This is not Washington!
Patient’s speak out.
Patient’s speak out.
Patient’s speak out.
Medicare Expenses are Rising Healthcare cost must be controlled- not
sustainable as it is Data now shows that there are savings in how
care is delivered We are a country of ingenuity and can figure
out how to solve the cost issue- new models are being developed to provide great care at lesser costs
All of us need to be involved to make certain reform is done right- ADVOCACY!
Why Payment Reform?
VALUE= QUALITY/COSTS
THE NEW MANTRA IN HEALTHCARE REFORM IS VALUE BASED PURCHASIN
Increasing cost of care and diminishing reimbursement for care
The increasing regulatory environment they live in now
The interference of insurers in medical decision making
The time we spend fulfilling the increasing burden of documentation
The intrusion into regulation of how we use EHR’s 340 B Program, inequality in reimbursement
compared with Academic and hospital based care The list goes on and on and on
What bothers your Oncologist
Evolving healthcare advances and increasing costs of delivering the new treatments
The increasing presence and control exerted by insurers and by Medicare policy
The MMA of 2003 The Affordable Care Act The regulatory environment of Healthcare
as it relates to Oncology practice Diminishing reimbursement
How did we get where we are?
We advocate for change Examples of change- integrated care models
like the CMMI COME HOME demonstration project, The COA OMH Model, United Healthcare and Aetna bundle care experiments
We advocate at a Congressional level for rationale change and educate Members and their staff regarding what the real world outside D.C. looks and feels like
We innovate
So what do we do??
WE ADVOCATE!
To maintain the viability of community based cancer care
To fairly reimburse practices for what they do To advocate to level the playing field with
academic centers and hospital based centers for the exact same services
To use the regulatory mechanisms fairly and rationally
For legislation to test models of oncology care that are integrated and cost saving at the same time
What are we advocating for and how?
COA Team on the Hill
Jeff Mortier’s take on Payment reform from a lobbyist and former House staff member
A View from DC
DISCUSSION
Wrap up thoughts
How we do this and how you can engage in payment reform
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