There is no doubt that the advent of accountable care organizations (ACOs) doesn’t necessarily pose a threat to community oncology practice but rather it shows us that we are going to need to practice cancer care in a more value-based manner going forward. Quality for cancer care delivery is what is really measured even more than costs and definitely more than quantity. And by putting quality metrics in place, organizations like ACOs and other organizations that have multispecialty groups will refer to oncology practices that are providing the best quality to their patients.
Likewise, payers may decide whether to embrace new technology or new programs that include community oncology practices whether medical, radiation, or surgical oncology, based on the ability of those practices to make quality improvements. An example would be in a community oncology group that can carefully monitor patients and avoid them from getting readmitted during their chemotherapy or avoid them from having emergency room visits for pain and complications related to chemotherapy.
Obviously, a cohesive program, including medical, radiation, and surgical oncology, with navigators and cure coordinators in a clinically integrated network is probably the correct model in the future for cancer care. Another option may be a so?called oncology ACO, and that model is being piloted in several places throughout the United States today.