Patient Voices in Value-Based Cancer Care: Priorities for the Biden Administration

Researchers at the National Pharmaceutical Council (NPC) and Discern Health published an article in the Journal of Clinical Pathways (JCP) that offers recommendations to the Biden administration to make cancer care more patient-centered. The researchers suggest that the key to elevating patient voices is using the right tools when developing a value-based payment (VBP) model: patient-reported measures (PRMs), tools that capture patients’ voices related to their care experiences and outcomes, and patient-reported performance measures (PR-PMs), tools that translate PRM responses into metrics to compare health care performance and track changes over time.

Past research has demonstrated that using PRMs in VBP models can lead to improved patient outcomes, including survival, while using PR-PMs can ensure that the physical, financial and psychological burdens experienced by cancer patients are included in the definition of and payment for value.

The authors analyzed PR-PMs in VBP models and found that these tools are very rarely used. This suggests that the Oncology Care Model (OCM), launched by the Center for Medicare and Medicaid Innovation (CMMI) five years ago as part of then-Vice President Biden’s Cancer Moonshot Summit, can do more to ensure that value is captured from the patient perspective. CMMI was preparing a new and improved VBP model in 2021, but the project has been delayed because of the COVID-19 pandemic. It has been re-scheduled to begin in June 2022.

The researchers suggest CMMI use this extra time to make additional improvements to its new oncology VPB model. The article recommends that CMMI include patients and caregivers throughout all phases of program development and implementation and develop patient-reported measures to fill measurement gaps in health-related quality of life, shared decision-making and goal concordant care. Additionally, the researchers suggested that CMMI reduce patient reporting burden by using standardized and validated measures. To help providers overcome PR-PM implementation barriers, the researchers recommended that future VBP models offer providers financial incentives.

As the Centers for Medicare and Medicaid Services moves forward with designing payment models to advance value-based care, incorporating PR-PMs offers a way to recognize patient voices in defining value. Given President Biden’s historical focus on cancer, these recommendations could help the new administration to develop an innovative VBP model for oncology. The key takeaway: listening to and prioritizing patient voices via PR-PMs is crucial to ensuring that patients receive high-value care.

The article draws from previous NPC and Discern Health research on the use of patient-reported measures (PRMs) and performance measures (PR-PMs) in oncology. It was co-authored by Kimberly Westrich, MA, NPC Vice President of Health Services Research, Theresa Schmidt, MA, Vice President at Discern Health, Jacqlyn Riposo, MBA, Senior Project Manager at Discern Health, Tom Valuck, MD, JD, MHSA, Partner at Discern Health, Mark McClellan, MD, PhD, Director of the Robert J. Margolis Center for Health Policy and the Margolis Professor of Business, Medicine and Health Policy at Duke University, and Ethan Basch, MD, MSc, Richard M. Goldberg Distinguished Professor of Medical Oncology and Chief, Division of Oncology at the University of North Carolina, and Physician-in-Chief at the NC Cancer Hospital.

Read the full article on the JCP website.