Tennessee Oncology And Blue Cross Blue Shield Launch New Value-Based Care Initiative

Program Serves As Model For Future Oncology Medical Home Programs

Wednesday, October 20, 2021

Tennessee Oncology and BlueCross BlueShield of Tennessee have kicked off an innovative value-based cancer care program to improve treatment coordination for thousands of Tennesseans. This venture launched earlier this month for BlueCross networks P, S, and L and will be one of the most comprehensive value-based arrangements for cancer care in the country, said officials.

As a value-based initiative, the program is designed to support high-quality, cost-effective health care to patients. The initiative follows BlueCross members at all phases of the cancer journey from diagnosis through treatment and follow-up, and providers earn financial incentives or penalties based on how well members’ care is coordinated and documented. BlueCross and Tennessee Oncology will:  
- ensure best practices are followed in care planning and treatment, 
- analyze treatment data to make sure care guidelines are met and patients receive the right treatment at the right time, and
- provide patient-centered care throughout the process.  

As the clinical partner in the Oncology Medical Home, Tennessee Oncology will maintain key quality designations including the Quality Oncology Practice Initiative Certification awarded by the American Society of Clinical Oncology. 

According to the American Cancer Society, there will be nearly 42,000 new cancer diagnoses in Tennessee in 2021 – and it’s no secret that the cost of treating the disease can be significant. Roughly 18,000 BlueCross members diagnosed with cancer undergo chemotherapy every year, with average claims of $75,000 for six months of treatment. Addressing those costs can help members and employer customers save on care.

“This program supports our members’ peace of mind by enabling access to the highest-quality, patient-centered care for their condition,” said Dr. Andrea Willis, senior vice president and chief clinical officer for BlueCross BlueShield of Tennessee. 

“The prevalence and cost of cancer care makes this initiative extremely valuable to our members and employer customers,” said Todd Ray, SVP corporate provider network management and Medicare products for BlueCross. “Tennessee Oncology’s commitment to demonstrating quality and value for our members, and their investment in the data analytics capabilities needed to support this type of program, have made them a great collaborator in advancing these objectives.”

The program was developed through a comprehensive evaluation of the most effective features of other value-based cancer care programs in recent years, including the Oncology Care Model overseen by the Centers for Medicare and Medicaid Innovation. The program also set a high bar for the data and technology infrastructure needed to support quality care throughout a patient’s cancer care journey, said officials.

“Our commitment to innovation and patient-centered care have always been core to the culture of Tennessee Oncology,” said Natalie Dickson, MD, president of Tennessee Oncology. “The current era of personalized medicine is especially encouraging for our patients and clinicians; however, affordability will continue to be a major challenge. As evidenced by this program, the role of the health plans is becoming increasingly important to enable us to fulfil our mission. This value-based care initiative will serve as a model for how clinicians and health insurers can collaborate to benefit patients.” 



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