In a new oncology program in Florida, Aetna is trying to combine the medical home model with access to advanced care and translational research.
Aetna and the Tampa-based Moffitt Cancer Center have created an "oncology medical home," aimed at addressing "rising health care costs, clinical inefficiency and duplication of services, and to make it easier for people to get the care they need," the organizations said.
Aetna and Moffitt, one of 41 National Cancer Institute-designated Comprehensive Cancer Centers, said the partnership relies on five operating principles.
One is "an orientation to the whole person." Moffitt physicians treating Aetna members with cancer are being tasked with arranging for all of their health needs, spanning chemo and radiation therapy, acute care, chronic care, preventive services and end-of-life care.
The second principle Aetna and Moffitt cite is striving for personalized, evidence-based care. Relying in part on Moffitt's clinical pathways system, care teams "will focus on designing treatment regimens based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice."
There is also coordinated care, a staple of the patient centered medical home in primary care, in which Aetna and Moffitt will work to help patients navigate the healthcare system, including needs beyond cancer care.
Under the principle of quality and safety, Moffitt is accepting "accountability for continuous quality improvement."
And the fifth principle promises "enhanced access to care." Rather than a cancer patient who is experiencing chemotherapy side effects or pain going to an ER on the weekends or evenings, they can access Moffitt clinicians through extended hours, digital or phone communications and open scheduling.
"The collaboration between Aetna and Moffitt Cancer Center will help define the value of care and serve as a model for value-based arrangements with similar institutions," said Michael Kolodziej, MD, Aetna's national medical director for oncology.
Jack Kolosky, the chief operating officer at Moffitt, said the oncology medical home "will enable Moffitt to provide personalized care to patients that is more effective and efficient."
Aetna covers about 1.5 million Floridians, and started using the medical home in oncology in 2013, in a partnership with Consultants in Medical Oncology and Hematology, a cancer care network in greater Philadelphia. Aetna now has 14 oncology medical homes in 10 states, including two others in Florida with Space Coast Cancer Center and Cancer Specialists of North Florida.
Among other insurers pursuing alternative models in cancer care, UnitedHealthcare's episode-of-care payment pilot recently brought in some promising data. In a study of 810 patients with breast, colon and lung cancers, the insurer found that paying oncologists upfront for an entire treatment regimen, regardless of the drugs used, yielded a 34 percent reduction in medical costs compared to projected spending, thanks in part to avoided hospitalizations.