Improving Value-Based Care Through Prognostic Testing


Medical care in the United States continues to move away from a fee-for-service model, increasingly working towards the promotion of value-based care. The Oncology Care Model (OCM), developed by the Centers for Medicare and Medicaid Services, serves as one of the major payment and delivery tools for practicing oncologists around the country.1 A significant amount of research has centered around how to best use the OCM to foreground the best possible care at the best possible cost.

Ray D Page, DO, PhD, FACOI, medical oncologist and hematologist at The Center for Cancer and Blood Disorders (Weatherford, TX), and colleagues investigated the impact on quality measures and care planning of implementing lung cancer testing as part of routine practice. In a study published in Managed Care,2 Dr Page and colleagues found that using the VeriStrat test accurately predicted therapeutic and treatment outcomes for patients with lung cancer, while helping patients and providers avoid expensive and ineffective treatments. “By providing independent prognostic information, the VeriStrat test is a validated, commercially available tool that physicians can use to improve cancer care planning and composite performance scores associated with quality payment models,” Dr Page and colleagues wrote.

Journal of Clinical Pathways recently spoke with Dr Page about the continued validation of the VeriStrat test, the role of testing within clinical pathways, and their effect on the OCM.

Can you talk about the OCM Quality Care Model discussed in your paper?

The OCM was created by Medicare in order to improve the quality of care, while also saving on costs. The quality measures put forth in this program are many; however, when treating patients with lung cancer, prognosis and expected response to therapy are always key considerations to prolong patient survival and maintain quality of life. For that reason, there are measures that we evaluate in this publication.

Can you summarize the objectives of your study and what you found, insofar as how prognostic tools such as VeriStrat can aid in achieving optimal quality measures.

It’s important to share knowledge around quality of care and available innovative tools with other physicians who treat patients with lung cancer. Therefore, the main objective was to offer insight to physicians as to how tools like VeriStrat can help them meet their OCM measures while also improve outcomes and the patient experience. Additionally, there are some prognostic tools that have been used a long time that help establish prognosis, and those can be used to help give us an understanding of a patient’s state prior to administering therapy. It also needs to be determined whether these tools are sufficient in facilitating these decisions, and if there is a need for more objective measures, such as a VeriStrat test, to do so.

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