Expert consensus on essential characteristics of oncology value-based payment

Area of Science:

• Oncology
• Health Economics
• Healthcare Management

Background:

• Value-based payment (VBP) models are increasingly central to oncology care delivery.
• The goal is to enhance quality, cost-effectiveness, and patient-centeredness.
• Understanding essential characteristics of effective oncology VBP models is crucial.

Purpose of the Study:

• To identify key elements and characteristics of effective oncology value-based payment models.
• To assess the importance and feasibility of these elements among oncology experts.

Main Methods:

• A modified Delphi process involving 9 diverse oncology experts.
• Two survey rounds utilizing Likert scales to evaluate VBP model elements.
• An in-person discussion to further refine expert consensus.

Main Results:

• Consensus was reached on the necessity of patient-centered care, risk adjustment, and oncology-specific outcome measures.
• Pay-for-performance and enhanced monthly payment models are feasible but face criticism regarding metrics and reimbursement.
• Dual-sided risk and cost-containment models show promise but present implementation challenges, especially for smaller practices.

Conclusions:

• Effective oncology VBP models require aligned stakeholder incentives and accommodation of clinical complexity.
• Future models must be iterative, supporting innovation, equity, and sustainability in cancer care.
• Barriers include stakeholder misalignment, financial risk, and lack of standardized benchmarks.