Healthcare reimbursement in SA is at a crossroads. Globally, there is a move towards value-based care, while fee-for-service is being phased out. Alternative reimbursement models are being adapted to incorporate outcomes-based reimbursements, which reward the delivery of value by physicians. The quest to curb the rising costs of cancer treatment without sacrificing patient outcomes has successfully been implemented in the US.
The Independent Clinical Oncology Network (ICON) recently hosted an event where Diana Verrilli of McKesson Specialty Health, based in the US, spoke about how value-based care has been successfully implemented in the US Oncology Network.
The principle of value-based care is where funders incentivise doctors for adding value and saving costs, based on measured outcomes. A shift to this kind of reimbursement has been shown to deliver benefits to all stakeholders in the sector – especially the patients.
The ICON team encountered the work of Diana Verrilli on a recent trip to the US as guests of US Oncology, which is the largest oncology network in the US, spanning some 400 sites of care with a membership of around 1400 oncology physicians.
The healthcare situation in the US is not dissimilar to that of SA. Speaking at the event, Dr Jacques Snyman, ISIMO Health CEO, said, “This is an opportunity for us to learn from how the US took ownership of the situation and made value-based care work for them.”
Read more about Verrilli’s findings in the next issue of Specialist Forum.