A pilot program is being developed by UnitedHealthcare and the University of Texas MD Anderson Cancer Center to explore the benefit of a preset, bundled payment for head and neck cancer care that includes chemotherapy, radiation and surgery. “Patients are going to know right upfront what the total cost is,” UnitedHealthcare’s Dr. Lee Newcomer said. The collaboration is among the first using bundled payments in a large, comprehensive cancer center. This new cancer care payment model for head and neck cancers focus on quality patient care and outcomes.
United Healthcare said cancer therapy, including drugs, makes up 11% of its commercial health plan spending.
The bundled payment method reimburses a care provider or hospital for a defined episode of care under a single fee or payment. This is a shift away from the common fee-for-service structure in which a care provider is paid for each treatment, drug, appointment or test. The program is based on MD Anderson’s extensive mapping of the complex tests, treatments, follow-up care and supportive services required for the most common head and neck cancer diagnoses. The pre-priced payment provides an incentive to focus on the essential elements of care and to avoid unnecessary steps. This careful mapping is expected to produce improved patient outcomes, lower costs and a better quality of life for patients.
Sounds great on paper. Who do you think will really benefit most: The patient, the hospital or the insurance company?