Anthem Blue Cross Of California Pilots Bundled Payments On Breast Cancer Treatment

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Anthem Blue Cross of California has partnered with Valley Radiotherapy Associates Medical Group, an oncology provider in Southern California, to provide an episode-of-care payment option for breast cancer patients.

By Maria Castellucci  | July 7, 2016

In its first step toward bundled care, Anthem Blue Cross of California has partnered with Valley Radiotherapy Associates Medical Group, an oncology provider in Southern California, to provide an episode-of-care payment option for breast cancer patients.

The rate covers all radiation therapy services provided to patients for the treatment of early-stage breast cancer. The price, which was not disclosed, is effective May 15, according to a news release.

This is the first cancer bundled payment program that Anthem has piloted, said Dr. Jennifer Malin, vice president for clinical strategy at Anthem.

The rate is available for patients with Stages 1-3 breast cancer because it often requires outpatient radiation treatment only, said Dr. Leslie Botnick, president of Valley Radiotherapy.

Malin said radiation treatment for breast cancer is a viable bundled payment option because studies show that women are often eligible for shorter treatment plans than what they receive. She said reimbursement policies may influence this excessive treatment. With bundled payments, revenue will be the same no matter how much radiation treatment they need, she added.

Valley Radiotherapy treats several hundred breast cancer patients in a year. The recurrence rate among its breast cancer patients is about 3%, Botnick said.

Malin said Anthem and Valley Radiotherapy will look at patient data after the program is implemented for several months. She said they may adjust the price depending on how long patients are treated.

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The Blue Cross Blue Shield Association is an association of 36 independent, locally operated Blue Cross and/or Blue Shield companies.