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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Patient perspectives on cost and quality measures in value-based cancer care
Alan Balch1, Michael Lahm2, Kimberly D Brunisholz3
1Patient Advocate Foundation, Hampton, VA, United States.
Introduction:
Patient perspectives and preferences are important when establishing quality and cost metrics for value-based payment (VBP) models, to ensure patient-centered cancer care and VBP incentives are aligned.
Methods:
Insights were gathered about value-based care (VBC) models from patients with Medicare and one of 4 common cancers (multiple myeloma, bladder, lung, and prostate) included in Medicare's Enhancing Oncology Model. This study included 4 virtual 2-hour focus groups and a 2-hour co-creation session. Aspects of cost and quality important to cancer care were identified (value is defined as the ratio of quality/cost).
Results:
Insights from the focus groups (n = 20) and co-creation session (n = 6) highlighted a lack of awareness about VBC and concerns about the effect of financial incentives on oncology care. Focus group participants identified shared decision-making and treatment effectiveness outcomes as the most important elements of quality. Co-creation participants highlighted a need for improved awareness about the implications of VBP incentives for oncology care decisions.
Conclusion:
In this exploratory qualitative research, patients with cancer expressed a need for transparency of VBC dynamics to help preserve the patient-physician relationship and their ability to receive innovative, affordable, and accessible care.
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