The Association of Northern California Oncologists (ANCO) serves 409 physician members in academic and community settings, as well as nurses, practice managers, and patients in the region. Recently, the organization has been particularly active in the area of provider-payer partnerships. José Luis Gonzalez, ANCO Executive Director, spoke with ASCO Connection about the affiliate’s activities and priorities.
AC: What led ANCO to take a leading role in the issue of provider-payer partnerships?
Mr. Gonzalez: Given input and feedback from ANCO member practices, hearing about provider-payer partnerships in other parts of the country, and as a result of an Economic Assessment of ANCO Member Practices, the ANCO Board of Directors educated itself and considered its role in provider-payer partnerships in California—learning about the available compliance models used by payers and vendors in the provider-payer partnership space and exercising its due diligence with respect to the various vendors on behalf of the membership.
It was the consensus of the Board that ANCO should take an active, but limited role in provider-payer partnerships. That is, ANCO’s role would be limited to informing, educating, and recommending that members proactively take advantage of front-end compliance programs such as Innovent Oncology and Via Oncology and negotiate provider-payer partnerships with their major third-party payers. We invited these organizations to work with ANCO in bringing comprehensive information about their pathways programs and how they have worked with practices and third-party payers to the membership. While the Board does not endorse one of these organizations over the other, it does endorse the concept of pathways and front-end (i.e., clinical decision point) compliance models such as those offered by these two organizations over all other models and vendors or potential partners involved in provider-payer partnerships
AC: What is the benefit of a front-end compliance model?
Mr. Gonzalez: ANCO found front-end compliance models using pathways (like Innovent and Via) to be most compelling because they are
- prospective, and
- used at the point of treatment planning.
Other models appeared to be payer-driven based on a retrospective analysis of utilization and the need to constrain drug utilization based on costs.
AC: How is ANCO working to educate and inform oncologists on the topic?
Mr. Gonzalez: ANCO published a special edition of ANCO FAX News (Vol. 9, No. 17) to announce its provider-payer partnership strategy, launched special webpages about the strategy, and invited Innovent and Via representatives to contribute information for dissemination to the ANCO membership (through updated webpages and items in the ANCO FAX News and webcast). We informed major California third-party payers of our strategy and invited them to work with ANCO in developing statewide models based on the principles exhibited by the Innovent and Via models.
AC: You did a presentation on the topic at a Meet the Leader session at the State Affiliates Booth during the recent ASCO Annual Meeting. How did it go? AC: What other priorities are keeping ANCO busy over the next year?
Mr. Gonzalez: A representative from the Medical Oncology Association of Southern California (MOASC) and I each shared information about our organizations’ provider-payer partnership strategies. The session was attended by other state society executive directors and a reporter from Oncology Times.
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