Wednesday, May 28, 2014

Insurers Push to Rein In Spending on Cancer Care

Originally posted in The Wall Street Journal on 5/27/14

Insurers are changing how they pay for cancer care, aiming to blunt soaring costs and push oncologists to adhere to standardized treatment guidelines.

The largest effort yet is set to be unveiled by WellPoint Inc., which will begin offering oncologists a $350-per-month payment for each patient who is on one of the insurer's recommended regimens. WellPoint, the No. 2 insurer in the U.S., will roll out its new program July 1 in six states and through its entire network by the middle of next year. Initially, it will focus on breast, lung and colorectal cancer, but it will expand to other forms of the disease.

Programs like WellPoint's and others around the country are part of an effort to smooth out wide variations in how doctors treat patients, which health experts say can be wasteful and don't always benefit patients. In cancer, insurers and health-care providers have been developing treatment protocols—sometimes known as "pathways"—that are supposed to represent the best and most efficient approaches, balancing cost, benefit and side effects. Insurers are then paying doctors according to how well they comply

Read the full story here.

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