Are there specific initiatives at Atena that other health plans can adopt for value based cancer care

Michael Kolodziej, MD, FACP

Videos - Payer-Provider


The law of the land precludes me from knowing too much about what other health plans are doing. I don’t want to go to jail. But we do talk to each other about our vision, and I think when you come to a meeting like the AVBCC meeting, you realize that there’s a certain consistency in the vision people have.

I think a lot about smaller health plans, about regional Blues plans and their ability to execute. I’ve even thought about the possibility that we could commoditize some of the things that we’re building.

But probably the easiest way is if we can get practices to really fire on all cylinders, they have a very, very compelling case to bring their dominant regional payer into the discussion, and utilize the platform that we help them build so they could succeed with that payer. I think that is the most likely way this is going to happen.

The relative consistency and approach of all the major national payers suggests that all of us want practices to think about how they’re using evidence?based medicine and how to document it. Absolutely consistent.

All of us are interested in getting a better end-of-life approach, some sort of standardized process where you have dialogue with the patient and find out what’s important to them. All of us are interested in enhancing triage, same-day office visits, things to keep people out of the ER, because ER use in at least half of hospitalizations are wasteful and potentially avoidable.