Clinical and financial expertise integrated with leading edge technology allows OPN to facilitate sustainable management of resources and ensure excellent oncology care.

OPN Care Management Services is a URAC accredited program that includes utilization management, prior authorization, data reporting and patient screening / program identification for patient support services. Care management addresses the Total Cost of Oncology Care, including drugs, radiation oncology and ancillary services such as labs and pathology, imaging studies and radiology.

Care Management brings significant insight to clinical and financial areas related to oncology care. The only way to implement a centralized approach focused on clinical and financial outcomes is with technology infrastructure. OPN collects data in real-time, then processes it to generate actionable reports. OPN is able to assist in planning, managing, implementing and optimizing care. With the Care Management Services, OPN provides tools for oncologists to operate successfully in value-based care models.

Collaboration is Critical

OPN interacts cooperatively with providers, ensuring consistent communication with their teams and delivering real-time, meaningful data which can result in critical information that providers can use. A network of peer-to-peer sub-specialists interface with oncologists to help navigate the constantly evolving landscape of effective oncology care. Collaboration and partnership are the focus of OPN and differentiate Care Management from most Utilization Management systems.

This service is a critical component in OPN’s partner relationships as it encourages a two-way dialogue with providers and payers that results in a more robust and collaborative process. It enables all parties to offer care that is better quality and more cost effective. This effort is enhanced when all key stakeholders, like providers, are included in the process.

Clinical Advisory Panel

An advisory panel of noted oncology experts provides independent analysis and clinical breadth for our partners. It is comprised of highly regarded sub-specialists in oncology care that provide unique diagnosis support for community practices. This resource can offer oncologists with a deep understanding of updated guidelines and other diagnosis-specific recommendations.

Benefits for All Parties

Care Management Services ultimately allows for better quality care at a lower cost. For payers, this program documents improved care delivery and lower treatment costs, which is historically difficult to measure. It also gives a detailed understanding of what is contributing to the cost of a specific group’s oncology care. Most payers understand that oncology is complicated to manage. OPN is able to furnish accurate and transparent information with a level of granularity that most payers have not encountered before.

These benefits also apply to providers. They often do not have adequate information at hand to understand if individual medication expenditures are high. OPN helps providers assess their drug spend so they can make more informed decisions regarding costs. As healthcare transitions to value-based contracting, this will become an important tool for oncologists. OPN helps providers with this challenge by providing real-time feedback such as analytics and transparent assessments that can help them identify operational opportunities in the value-based care space, while ensuring that they can provide the same standard of care for their patients. Oncologists often understand that they need to cut costs to be competitive and secure value-based contracts, but they may not be able to envision a clear path towards this goal.