# Patient perspectives on cost and quality measures in value-based cancer care

## TL;DR

This study explores how cancer patients view cost and quality in value-based care, emphasizing the need for transparency and shared decision-making.

## Contribution

The study provides new insights into patient perspectives on value-based cancer care and highlights gaps in awareness and transparency.

## Key findings

- Patients emphasized treatment effectiveness and shared decision-making as key quality measures.
- There is a significant lack of awareness and understanding of value-based care models among patients.
- Patients want transparency about how financial incentives affect their care and reassurance that cost efforts won't compromise quality.

## Abstract

Patient perspectives and preferences are important when establishing quality and cost metrics for value-based payment (VBP) models, to ensure patient-centered cancer care and VBP incentives are aligned.

Insights were gathered about value-based care (VBC) models from patients with Medicare and one of 4 common cancers (multiple myeloma, bladder, lung, and prostate) included in Medicare's Enhancing Oncology Model. This study included 4 virtual 2-hour focus groups and a 2-hour co-creation session. Aspects of cost and quality important to cancer care were identified (value is defined as the ratio of quality/cost).

Insights from the focus groups (n = 20) and co-creation session (n = 6) highlighted a lack of awareness about VBC and concerns about the effect of financial incentives on oncology care. Focus group participants identified shared decision-making and treatment effectiveness outcomes as the most important elements of quality. Co-creation participants highlighted a need for improved awareness about the implications of VBP incentives for oncology care decisions.

In this exploratory qualitative research, patients with cancer expressed a need for transparency of VBC dynamics to help preserve the patient–physician relationship and their ability to receive innovative, affordable, and accessible care.

To understand patient perspectives on value in cancer care, this study explored real-world insights around value-based care (VBC) models among Medicare patients with cancer in the United States. Overall, there was a lack of awareness of VBC models and a perceived lack of transparency on whether their provider took part, despite most patients indicating they would want to know if value-based payments were affecting treatment decisions. Most patients cited treatment effectiveness and shared decision-making as the most important measures and aspects of quality. Patients expressed a need for transparency of VBC dynamics, education on value-based payment models, and reassurances that cost-containment efforts would not compromise care quality, the patient-clinician relationship, or their ability to receive innovative, affordable, and accessible care. Including patient perspectives is essential to achieving shared accountability and optimal health outcomes in VBC. Patients emphasized the need for a variety of stakeholder perspectives to be considered to ensure that real value is delivered, shared decision-making is prioritized, and quality is preserved, while making innovative care affordable and accessible for patients. Understanding and aligning patient values with current model components will support delivery of true VBC.

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