OBJECTIVES: In recent years, US healthcare expenditures increased at nearly double the rate of the consumer price index. Unlike single-payer systems, U.S. regulatory approvals and clinical practice guidelines do not typically account for costs. The introduction of value-based care (VBC) attempts to change the status quo by juxtaposing quality with cost of care. Many oncologists are facing this change via the oncology care model (OCM). This study aimed to describe the perceptions and practical implications of VBC programs on community-based oncologists.

METHODS: A live meeting held in April of 2019 convened 55 community oncologists from the U.S. Participants attended multiple discussions focused on the impact of VBC models on the practice of medicine. Physician perceptions were surveyed using an audience response system and responses were summarized using descriptive statistics.

RESULTS: Among 55 oncologists surveyed, 64% believed VBC programs are needed to reduce cost of care and 42% believed they are necessary to improve the quality of patient care. Participants in VBC reported increased palliative care referrals (62%) and reduced emergency department visits (56%) and hospitalizations (48%). Over one-quarter (27%) of those surveyed reported VBC improved quality of care. In terms of cost savings, 39% of providers reported VBC resulted in savings to the health system, 13% savings to patients, and 13% savings to their practice. Over 76% of providers reported an increase in daily workload. VBC participating practices hired additional staff (patient advocates: 49%, administrative: 40%) and practitioners (advanced practice providers: 40%, physicians: 11%).

CONCLUSIONS: U.S. community oncologists believe VBC is necessary for cost control and improving quality of care. Participating practices have responded to current demands by increasing staff. Further research is required to understand if these changes are sustainable from a cost and workload perspective given the many demands placed on the community oncologist in addition to patient care.