Amy Ware, Principal Consultant at OncoEdge Advisory Partners, shared on LinkedIn:
“Today, Humana, Evolent, and American Oncology Network announced an oncology model that removes traditional prior authorization for most anticancer drug therapies at participating practices that meet established quality and treatment standards.
This is worth watching because it addresses a fundamental issue in payer-provider relationships: whether demonstrated clinical performance changes how care is managed.
Payers have a responsibility to manage cost and quality. Providers must be accountable for both. When that accountability is established, oversight should evolve rather than remain another approval requirement.
The model still has to deliver. Its value will depend on timely treatment, lower administrative burden, responsible spending, and appropriate clinical flexibility.
But the underlying principle is sound: payers should not need to approve every oncology treatment decision when a practice has already demonstrated that it delivers consistent, evidence-based care.
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