Bundled payments for cancer care may make a lot of sense, especially too patients and families who must monitor and pay complex sets of bills. But the opportunity also raises some questions for providers and payers.
A whitepaper from Booz & Co. — "Bundled Care: State of Play, Lessons Learned and Future Prospects" — explores the pros and cons of oncology bundles. For instance, on the up-side, there are well-tested and nationally recognized protocols for treatments for many types of cancer. On the down-side, cancer care is a highly charged issue, and payers have been reluctant to manage cancer spend. They do not want to be perceived as denying coverage to cancer patients.
Aside from these benefits and drawbacks, among others, there are also four unanswered questions surrounding cancer care bundles. They fall under four specific issues, according to the whitepaper.
"Bundleability"
1. Which cancers are shifting toward the personalized medicine end of the spectrum, and which will be considered more predictable in their treatment regimens?
Appropriateness of care
2. What kind of "care warranty" will be offered with cancer care to ensure appropriate care is given?
Volume requirements
3. Is it possible for cancer care bundles to have adequate volumes for the model to thrive without Medicare's participation?
4. How will bundles affect independent oncologists who do not have scale but provide needed local access?
Consequences
5. Will bundled products slow the progressive innovative protocols for cancer treatment, which might represent significant breakthroughs?
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