Transform Your Oncology Network
We optimize your network to deliver greater value while enhancing care.
With the newest cancer drugs costing $20,000 or more per cycle, rising oncology spend has not delivered a commensurate improvement in care.
Moving Beyond Prior-Authorization
Until now, payers have relied on utilization management (UM) and prior-authorization methods to manage growing oncology costs – an approach akin to restricting automobile trips rather than improving vehicle performance.
Performance-Based Approach
Oncology Resource Networks (ORN) offers a performance-based approach to deliver greater value from your oncology network while enhancing care. Our approach ensures that your providers improve performance without needing a case-by-case UM gatekeeper to achieve your benchmarks.
Enhance Performance with the ORN Oncology Value Profile™
ORN uses a proven method to identify and measure value in oncology care – the ORN Oncology Value Profile.™
Built on a foundation of evidence-based medicine and patient-centered care, we use ten metrics for this performance profile of the providers in your network. These performance indicators align 100% with the Quality Measures adopted by CMS, and go a step beyond to discover productivity opportunities that will deliver increased value from your network.
| The ORN Oncology Value Profile™ | |
|---|---|
| 1. | Coordination of Care |
| 2. | Compliance with Evidence Based Guidelines |
| 3. | Consideration of Treatment Cost (Pathways) |
| 4. | Generic Prescribing Rate |
| 5. | Emergency Department Admissions |
| 6. | Inpatient Admissions/ Readmissions |
| 7. | Completion of Advanced Directives |
| 8. | End-of-Life Management |
| 9. | Patient Satisfaction |
| 10. | Total Cost of Oncology Care |
How it Works: The ORN Network Transformation Toolkit
We optimize the value of your network by working directly with your providers. Without limiting or narrowing the network, we raise the bar of performance to balance quality and affordability with access to high-quality cancer care.
Our Toolkit includes:
- The Oncology Spend Profile™ – We perform a detailed analysis of a payer’s claims data to produce an Oncology Spend Profile. This helps the client understand their baseline cost of cancer care, identify opportunities to increase value across the book of business, and develop a strategic network plan to achieve quality and affordability goals.
- The Oncology Value Profile – The initial score represents a baseline of network performance. We then produce monthly scorecards to measure network progress for each practice using a continuous quality improvement model.
- Monitoring and Optimization – We implement targeted programs as needed to improve operational and clinical performance of the providers in your network, preparing providers to be successful in risk-sharing/bearing arrangements. We focus on under-performing providers and areas of deficiency, leaving high-performing providers alone.
- Aligned Financial Incentives – As the program matures, we begin to shift risk to the provider network, beginning with shared savings and moving toward models that include both up and down-side risk.
Achieve Measurable Results
In a recent case study, ORN improved an oncology practice’s performance by 91 percent in 90 days, representing $23,000 per million members per month, or a savings potential of $3.5M across a network of providers serving 50K Medicare Advantage and Commercial lives.
