Practice Story

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