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Alternative Payment Models and Patient Care


Amanda Forys, MSPH: I know the oncology care model has been something that we’re testing out to see if more involved provider interaction and treating that patient in the Medicare world on an almost per-member, per-month basis where you’re giving that provider that payment to manage the patient.

Do you think payment systems like that—that do some type of encapsulated full service, or comprehensive service, more involved with Medicaid or more involved for the uninsured even just making sure that offices are doing that beyond Medicare—that that’s the kind of model that you’d like to see?

Christy M. Gamble, JD, DrPH, MPH: Yes, that’s a great model to follow. It really is. Like I said, there’s still those little holes and gaps where if you work with those specific population advocacy groups we can fill those, but really giving that specialized attention to the patient is what’s really needed.

Medicare is doing some things very well, and doing some things not so great. We’re all for innovation and trying out things to see where the gaps are. I would hate to say, “No it’s not working,” I would rather say that “It’s going along very well, but we still see some gaps that we would like to fill there.”

But coming up with ideas and being really innovative in reaching every patient population—we’re always giving a thumb up for that.

Amanda Forys, MSPH: Yes, coordinated care models, I know we’re always trying to figure out better ways to provide coordinated care, so I definitely think that since you mentioned the medical transport, getting people to where they need to be and thinking about that, it’s a broader spectrum of treating the patient, not just the disease that’s important.

Christy M. Gamble, JD, DrPH, MPH: Yes, absolutely.

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