Managed Care - September 2008 - (Page 48)

PLAN WATCH Plan Hopes $3,000 per Oncologist Results In Improved Cancer Care Blue Cross Blue Shield of Michigan makes it easier for oncologists to get information that will help them improve quality, cut costs By Frank Diamond hen health plans encourage doctors to improve quality by comparing their performance with the best-practice guidelines that medical associations champion, physicians will often respond, “How?” As in how will they find the time and/or resources to manage this? Blue Cross Blue Shield of Michigan responds by giving doctors money. That’s the idea behind the insurer’s working with 180 oncologists in 11 physician groups caring for about 16,000 patients. The plan pays the doctors $3,000 each to pull charts and compile information on cancer care. That information is then added to the database maintained by the American Society of Clinical Oncology (ASCO). “It’s the first time that such a large and coordinated effort in a single state is using a na- W tional database to promote excellence in cancer care and, at the same time, rewarding physicians for these improvement efforts,” says Robert Chapman, MD, director of the Josephine Ford Cancer Center at Henry Ford Medical Group, one of the participating practices. National registry The program allows oncologists to quickly tap into ASCO’s cancer treatment data on tens of thousands of patients. The insurer, which plans to spend about $500,000 on the program this year, hopes that this will encourage the sharing of information in the field of oncology. The $3,000 is used to cover the cost of a physician joining ASCO and an oncology practice’s tapping into the Quality Oncology Practice Initiative (QOPI), ASCO’s database, according to David Share, MD, MPH, the health plan’s senior associate medical director of health care quality. Oncologists participating in BCBSM’s Physician Group Incentive Program are asked to join ASCO if they are not already members. The oncology practices will register for ASCO and submit data twice a year to ASCO’s QOPI database, which can also be described as a registry. The ASCO registry draws information from about 385 oncology practices in the country. Participating practices All oncology practices in the state were eligible to participate in Blue Cross Blue Shield of Michigan’s program aimed at improving cancer care. These 11 signed up: Physician group University of Michigan Health System, Faculty Group Practice United Physicians United Oakwood Providers Henry Ford Medical Group Oncology Physician Resource Quality Partners of Michigan St. John HealthPartners Oakland Physician Network Services Michigan State University Health Team Sparrow Family Medical Services Integrated Health Partners Location Southeastern Michigan–Ann Arbor Bingham Farms Dearborn Detroit Royal Oak Royal Oak Warren Waterford Mid-Michigan– East Lansing Mid-Michigan– East Lansing West Michigan–Battle Creek National standards “The oncology practices get the data, BCBSM doesn’t,” Share explains. “The physicians assess their practices against national standards. They examine the extent to which there is variation in practice. Then they take that learning and use it to guide improvement in systems of care. What they report to BCBSM is the processes they engage in, the learning they derive from the information, and the actions they take to alter practice and improve quality and efficiency.” 48 MANAGED CARE / SEPTEMBER 2008

Table of Contents Feed for the Digital Edition of Managed Care - September 2008

Managed Care - September 2008 Editor’s Memo Contents Legislation & Regulation News and Commentary Medication Management Compensation Monitor Archimedes Lends Hippocrates a Hand Some Other Predictive Modeling Programs Messing With Medicare Advantage The Trouble With MAC MedPAC’s Suggestions Sound Familiar The Leader in Patient Satisfaction Formulary Files Plan Watch Tomorrow’s Medicine Ad Index Outlook

Managed Care - September 2008

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