Practice Wins Exclusive Coverage of >125K Members in Health Plan
Situation
Practice offers high-quality and cost-effective care but has excess capacity
The US Oncology Network Approach
- Developed comprehensive care model with shared risk components – referral volume
- Used financial/actuarial expertise to model and develop capitalized payment
- Practice and third party payer crafted an exclusive agreement whereby all covered patients are cared for by the practice; driving down the total cost of care and creating value through significant patient growth
Result
- Exclusive coverage drives 150% increase in medical oncology visits and 300% increase in radiation visits
