Insurance reimbursement in the oncology market

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Insurance Reimbursement in the Oncology Market
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Oncology Care Model New payment models,
especially for those providing oncology medical
services, have been designed to improve the value
and effectiveness of medical care. For this, the
Centre of Medicare and Medicaid Innovation
devised a new model called the 'Oncology Care
Model
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• This model aims for
• Enhanced care
• Smarter spending
• People in good health

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Performance based Oncology Care
The model addresses three key issues in the
oncology practice that believes in value-based
agreements, and are the cost drivers of oncology
billing and coding 1. Avoiding
Hopspitalization As per the innovent program, a
nurse call center is established in which
innovent nurses have access to the patient's
medical record.
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2. Reducing Chemotherapy cost This has to be
done while keeping the costs low. This can be
achieved by conducting conversations on advanced
care and planning, pursuing clinical pathways
that have been accepted throughout, and
regulating the delivery of care and business
operations. 3. Standardization and resources
Use resources in a variable manner and use
clinical pathways as a practice. Clinical
pathways tend to reduce the unnecessary variables
in the treatment of cancer.
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