The Future of Value-Based Oncology Care: an Interview with Thyme Care - Kellogg’s is going to war over Mexico’s nutrition label rules. A similar fight is coming to the U.S.

The Future of Value-Based Oncology Care: an Interview with Thyme Care - Kellogg’s is going to war over Mexico’s nutrition label rules. A similar fight is coming to the U.S.

Value-based care is a hot topic in the healthcare industry, and it has made its way into oncology care as well. The Oncology Care Model (OCM) was a game-changer in terms of how the oncology community approached value-based care. However, it had its limitations. The OCM relied primarily on administrative claims data, which did not provide specific information about a patient's cancer diagnosis, histology, molecular characteristics, disease stage, and other important factors. This led to poor specificity of cost benchmarks against real cancer treatment episodes.

To address these limitations, CMS introduced the Enhanced Oncology Model (EOM). The EOM is a more focused version of the OCM, but it comes with its own set of challenges. The EOM includes a smaller, higher-risk patient population and additional requirements such as electronic patient-reported outcomes (ePROs) and Health Related Social Needs (HRSN) screening. This makes the program more operationally complex for practices to execute. Additionally, the EOM has higher thresholds for performance-based payment, making it more difficult for practices to achieve shared savings.

Despite its challenges, the EOM is important for driving value-based care and improving outcomes in oncology. CMS launching a program like the EOM changes the conversation around fee-for-service (FFS) vs value-based care in positive ways. It motivates people to try new things and succeed in value-based oncology care. It also gives more oncology practices experience in value-based care, which is crucial for improving outcomes and reducing costs.

One of the upsides of the EOM is that it provides oncologists with an opportunity to participate in value-based care. This is important because the majority of oncology care today is still delivered in fee-for-service models. By participating in the EOM, oncologists can gain experience in value-based care, which will be valuable in winning new contracts, especially as more commercial payers seek to partner with practices that have this experience.

However, the EOM also has its downsides. It is operationally complex, and there are financial implications involved. Participating practices and physicians are responsible for the costs of drugs, which are often the highest cost areas in oncology care. Additionally, the reporting requirements for the EOM are considerable, adding to the logistical burden for practices.

In the world of nutrition labeling, Kellogg's is leading the fight against Mexico's policy that requires warning labels on the front of boxes of unhealthy foods. This policy aims to educate consumers about excess sugar and fat in these products. Kellogg's has sued the Mexican government over this labeling policy, as it would mean their iconic mascots, such as Tony the Tiger and Toucan Sam, would be banned from appearing on packaging with warning labels.

Kellogg's has gone to great lengths to keep their mascots alive in Mexico. They have curated a Spotify playlist, starred in commercials, and even had drone light shows featuring their likenesses in the sky. In supermarkets, Kellogg's is advertising new versions of their products that claim to be low in added sugar. They have replaced sugar with the sweetener allulose, which is not classified as a sweetener by the Mexican government. Other companies, like Coca-Cola and Kraft Heinz, have also found loopholes in the labeling policy to avoid including warning labels on their products.

Similar policies are now being considered in the United States, with the Food and Drug Administration studying the idea of front-of-package labels. While the details of the policy have not been finalized, advocates in both Mexico and the United States anticipate a long political fight with the food industry. The industry has a history of fighting against policies aimed at promoting healthier choices.

In conclusion, the future of value-based oncology care is promising but comes with its challenges. The EOM provides an avenue for improving outcomes and reducing costs in oncology, but it also presents operational complexities and financial implications for participating practices. Similarly, the fight over nutrition label rules in Mexico and the potential for similar policies in the United States highlight the ongoing battle between the food industry and regulators aiming to promote healthier choices. Despite these challenges, there are actionable steps that can be taken to drive value-based care and improve health outcomes:

• 1. Invest in care navigation: Care navigation is crucial to value-based care, but it is not widely reimbursed. Practices should explore ways to incorporate care navigation into their models, as it can help improve patient outcomes and reduce costs.

• 2. Embrace innovation: Participating in value-based care models like the EOM provides an opportunity for practices to innovate and learn what works and what doesn't. Practices should be open to trying new approaches and adjusting their strategies based on the data and feedback they receive.

• 3. Advocate for policy changes: Oncologists and healthcare professionals should advocate for policy changes that support value-based care and promote healthier choices. This includes pushing for reimbursement for care navigation services and supporting front-of-package labeling policies that educate consumers about the nutritional content of food products.

By taking these actionable steps, the healthcare industry can continue to move towards a value-based care model that improves outcomes, reduces costs, and promotes healthier choices for patients.