Our chief medical officer speaks with Oncology Care Partners CEO Erich Mounce about their model for delivering the best patient experience possible while advancing value-based cancer care.
If you had the chance to create a high-value oncology practice from scratch, what would it look like? That’s the question that Oncology Care Partners (OCP) has been answering since launching in early 2022. Created via a partnership with Evolent and a private equity firm, OCP is establishing oncology practices that are focused on delivering the best patient experience possible while advancing value-based cancer care. The company opened its first three sites early this year—one in Surprise, Ariz., and two in Miami, Fla.—and plans to open another in Jacksonville, Fla., later this year. Our chief medical officer, Dr. Andrew Hertler, recently interviewed OCP Chief Executive Officer Erich Mounce about the model and his outlook on value in oncology.
Hertler: What does value mean in oncology care? What does it look like for patients?
Mounce: I believe that if you focus on a care journey that gives a patient a great outcome, value comes naturally. When you focus on the entire journey, the patient truly understands their diagnosis and treatment options, thanks to continued high-touch navigation. The patient has access to the most effective drugs because providers are using high-value clinical pathways and have access to clinical trials. The patient has the care team support to adhere to their care plan, manage physical and mental side effects, and avoid the emergency room. Finally, throughout the process we’re communicating and coordinating with their primary care provider.
Hertler: I’m glad you mentioned primary care providers because they often call cancer care a “black box.” Could you talk about how your model engages them?
Mounce: Certainly, the oncology practice needs to give regular updates to the primary care practice. Unfortunately, that doesn’t always happen in the real world.
At Oncology Care Partners, we’re engaging primary care providers more deeply. At the end of active treatment, we have a recorded telemedicine discharge visit with the primary care doctor, the oncologist and the patient where the patient’s care is handed off. This ensures everyone is on the same page. That PCP knows they are empowered to manage the patient’s care during this survivorship phase, whether it’s writing prescriptions for hormonal therapy or ordering annual mammograms. Too often, cancer patients continue to see their oncologist 15 or 20 years after active therapy, while a primary care provider could effectively manage this stage.
Hertler: What else is Oncology Care Partners doing that other practices aren't?
Mounce: First, we're not catering to both a fee-for-service world and a value-based world. We're totally about delivering care on the high value side. It’s about focusing on the patient and controlling the overall cost of oncology care without compromising outcomes. If you have novel payment relationships, you can invest those savings into a better care journey.
Second, we’re not focused on making a margin on drugs. In fee for service, you constantly look at designing a formulary that results in a good drug margin through higher reimbursement or more advantageous rebate structure. It’s hard to truly align with high value care.
Hertler: It’s great to say we’re going to deliver high value oncology care, but it’s not like flipping a switch. How do you engage your oncology providers?
Mounce: Aligning incentives is a big piece. None of our physicians are paid based on work productivity, collections or billing. We have incentives around patient satisfaction, around adherence to care pathways, and around clinical trials enrollment. There are also incentives around spending at least an hour with every new patient and 30 minutes or more in follow-up visits.
None of our physicians are paid based on work productivity, collections or billing. We have incentives around patient satisfaction, around adherence to care pathways, and around clinical trials enrollment.
Physicians love to hear that they can spend more time with patients. Yet, many are conditioned to move from room to room every 15 or 20 minutes. You have to break that cycle, and also show them that it can be done without affecting their compensation.
Hertler: What do you think will be the most important future drivers of value in oncology care?
Mounce: I’ll put the world of innovative drug therapy aside because I'm not a physician. But let's talk about other drivers. One is at-home therapy. I'm not yet ready to advocate chemotherapy entirely at home, but after the the first couple treatments it may make sense. However, hydration and other services can and should be offered to be delivered at home.
Also, the continued innovation around telemedicine is going to be a strong lever. My dream is that the patient has the ability to make all appointments, see all of their care plans and virtually connect with their care team 24/7. It's out there in pieces but it's still not put together. The patient should also have the ability to use telemedicine to access supportive care, whether it’s for pain, nausea and vomiting, infertility, or mental health issues.
Finally, I think payment will be based much more on outcomes—not just survival but also things like patient experience. Did they feel like their care plans truly reflected their goals? That’s not how the field has looked at outcomes in the past.
