Developing a high performing network of oncologists is essential to improve quality that also reduces costs.

What defines the specific traits of a high performing physician’s network can elicit a multitude of opinions.1 For some, high performing networks (HPNs) deliver “high-quality care that also is efficient care,” with lower total costs for health programs.2 The Center for Medicaid and Medicare Services (CMS) distills it down to “better care, smarter spending” and “healthier people.”3 

HPNs and specialty care such as oncology have attracted increasing attention due to the ever-increasing cost of treating cancer. Oncology groups are looking to streamline a patient’s care journey through advanced care co­ordination with a focus on quality to drive care that reduces costs while maintaining or improving quality.

A critical part of developing HPNs requires medical leadership to work closely with oncologists so they are Value Based Care (VBC) aligned when treating cancer. OPN Medical Director, Walter Tsang, MD notes that as VBC approaches are not part of routine training for oncology professionals, “many oncologists do not have a value-based mindset and often make clinical decisions that result in high utilization, without benefiting the patients. This is especially important in cancer care where many day-to-day decisions are gray areas and are subjective, without sufficient guidance from research evidence.”

In order to establish a durable, high-performing oncology network it is critical to recruit oncologists who recognize the advantages of VBC and strategically incentivize them to focus on value not volume.4 In addition, a robust set of analytic clinical tools that leverage AI and clinical electronic medical records can help oncologists make cost-effective clinical decisions in everyday practice. A key element in developing HPNs centers on metrics and how these metrics are measured (see sidebar).5

Harnessing Metrics to Optimize Networks 

HPNs require reliable real-time metrics that help oncologists understand how they are performing relative to benchmarks of an entire network. Advanced analytics revolving around utilization, quality and cost can help care teams gauge their performance and identify issues that need to be addressed. These measurements can cover clinical issues such as patients given chemotherapy in the last 30 days of life or patient experience statistics like Net Provider Scores (see Spotlight). 

Spotlight: Net Promoter Score (NPS)

Net Provider Score Dashboard

This example of an OPN NPS dashboard gauges patient experience by asking how likely they are to recommend a healthcare provider on a 0-10 scale. The end NPS score is calculated by subtracting the percentage of detractors from promoters, resulting in a score from -100 to 100. This score is calculated by subtracting the percentage of “detractors” (0-5) from the percentage of “promoters” (6-10).”6 This offers oncology groups a better understanding as to how cancer patients feel about their oncology care team. In the dashboard below the average NPS is 78.1%, significantly above the national average of 50%.

For further information, please contact:
Adam Goldston (email)
Chief Growth Officer
OPN Healthcare

  1. https://www.sciencedirect.com/science/article/abs/pii/S1553725016300459 ↩︎
  2. https://actuary.org/high-performance-networks/ ↩︎
  3. https://www.cms.gov/newsroom/fact-sheets/better-care-smarter-spending-healthier-people-improving-quality-and-paying-what-works ↩︎
  4. Abduljawad A, Al-Assaf AF. Incentives for better performance in health care. Sultan Qaboos Univ Med J. 2011 May;11(2):201-6. Epub 2011 May 15. PMID: 21969891; PMCID: PMC3121024. https://pmc.ncbi.nlm.nih.gov/articles/PMC3121024/ ↩︎
  5. https://www.ncbi.nlm.nih.gov/books/NBK584191/table/ch14.Tab1/ ↩︎
  6. https://info.pressganey.com/press-ganey-blog-healthcare-experience-insights/unlocking-the-power-of-nps-in-healthcare*https://info.pressganey.com/press-ganey-blog-healthcare-experience-insights/unlocking-the-power-of-nps-in-healthcare ↩︎