Bundled Payments for Patients with Head, Neck Cancer Launched at MD Anderson Cancer Center

by Richard Quinn •

Curbing Spending

Rena Conti, PhD, assistant professor in the departments of pediatrics and public health sciences at the University of Chicago, said that pilot programs like the one at MD Anderson are a clear response to the need for getting a handle on cancer spending. Starting small with a program that might encompass as many as 150 patients over two years is a smart approach, she added. “Here’s an opportunity to learn how to manage a complex patient population and a complex disease type without putting a lot of practice money at risk,” she said.

She anticipates that Medicare, “the dominant payer for cancer treatment in America,” will eventually move away from fee for service to alternative payment models and that pilots like the MD Anderson initiative will help prepare physicians and institutions for that transformation.

“It’s important to get a handle on what costs you can control and what aspects you can’t control as a practice, and these opportunities to work with private insurers, either for a set of cancers or for a select cancer, are first opportunities for practices to figure out … what they can and cannot negotiate for in anticipation for this becoming a reality in fee-for-service Medicare.”

Richard Quinn is a freelance medical journalist based in New Jersey.

The 1-2-3s of the Pilot Program

The pilot program from MD Anderson Cancer Center and United Healthcare provides a set sum for payment coverage for head and neck cancers.

The program, by the numbers:

  • 150: Total patient count expected.
  • 100,000: Amount in dollars the highest payments will exceed.
  • 30+: Patients enrolled so far.
  • 8: Payment bundles available, depending on patient services required.

Source: MD Anderson Cancer Center