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UnitedHealth Group launches pilot program for chemotherapy payments Posted: October 18th, 2010

By Maryalene LaPonsie

One of the nation's largest insurers, UnitedHealth Group, has announced a pilot program that could potentially change the way cancer treatments are administered. The insurance company is working with five medical practices to test a new model of reimbursement for chemotherapy and cancer care.

Traditionally, oncologists--physicians who specialize in the treatment of cancer--are reimbursed based upon a fee-for-service model. UnitedHealth Group argues that this method encourages physicians to recommended costly services that are either unnecessary or unproven.

In its test areas, the company will begin paying for cancer care with a lump sum amount that has been predetermined by physicians. The amount is to be based on the cost of standardized care for common cancers such as that of the breast, colon and lungs. The practices involved in the study are located in:

  • Dayton, Ohio
  • Fort Worth, Texas
  • Kansas City, Missouri
  • Marietta, Georgia
  • Memphis, Tennessee

Each practice must choose a standardized chemotherapy regimen that it intends to follow. Doctors are free to change treatment or medications at any during a patient's care, but UnitedHealth Group's reimbursement will remain based upon the initial regimen selected.