2012
DOI: 10.1177/1947601912448958
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Biomarkers, Bundled Payments, and Colorectal Cancer Care

Abstract: Changes in the management of cancers such as colorectal cancer (CRC) are urgently needed, as such cancers continue to be one of the most commonly diagnosed cancers; CRC accounts for 21% of all cancers and is responsible for mortalities second only to lung cancer in the United States. A comprehensive science-driven approach towards markedly improved early detection/screening to efficacious targeted therapeutics with clear diagnostic and prognostic markers is essential. In addition, further changes addressing ri… Show more

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Cited by 13 publications
(9 citation statements)
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“…At a time when payers, struggling to thrive in the current dynamic health care environment, must clearly understand the cost of patient care, 3 they ''are definitely on board with biomarker tests, particularly when it means that they are paying for drugs that patients will likely respond to-and conversely are not paying for several months of drugs or chemotherapy that will have little positive effect.'' 8 But it has been difficult to ''get a handle'' on biomarker test payment because payment requirements evolve and change over time, payers approach payment in different ways for different technologies, 9 and the majority of payers pay for diagnostic molecular tests separately from the associated therapy.…”
Section: Cancer Biomarker Payment Todaymentioning
confidence: 99%
See 2 more Smart Citations
“…At a time when payers, struggling to thrive in the current dynamic health care environment, must clearly understand the cost of patient care, 3 they ''are definitely on board with biomarker tests, particularly when it means that they are paying for drugs that patients will likely respond to-and conversely are not paying for several months of drugs or chemotherapy that will have little positive effect.'' 8 But it has been difficult to ''get a handle'' on biomarker test payment because payment requirements evolve and change over time, payers approach payment in different ways for different technologies, 9 and the majority of payers pay for diagnostic molecular tests separately from the associated therapy.…”
Section: Cancer Biomarker Payment Todaymentioning
confidence: 99%
“…Concerns about limited resources, appropriate patient selection, and costeffectiveness of cancer biomarkers is not new 21 ; however, the current economic climate has added rigor and urgency to these concerns. 3,17 Cost-effectiveness and cost-utility studies are commonly used to make payment decisions for new drugs and expensive interventions . .…”
Section: Cost-effectiveness Cost-effectiveness Analysismentioning
confidence: 99%
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“…Under a bundled payment mechanism, providers are at risk for overutilization and outliers. 257 CMS began experimenting with bundled payments for coronary bypass in the late 1990s, which resulted in $17 million in savings in the first 27 months of the program. 258 CMS is currently considering implementing bundled payments for hospitals and common inpatient services.…”
Section: Carve-outs Capitation and Managed Behavioral Healthmentioning
confidence: 99%
“…2 Most of this expense is concentrated in the first year after diagnosis, as a result of multimodality treatment costs. 4,5 Traditionally, Medicare makes separate payments to these multidisciplinary providers for each service they perform for the beneficiaries (ie, fee-for-service payments). This approach results in fragmented care and a compartmentalized delivery system, with multiple providers across many health care settings.…”
Section: Introductionmentioning
confidence: 99%