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    Urology-specific APMs to encompass PCa, BPH, OAB

     

    Urology groups in LUGPA are integrated practices and comport with the concept of utilizing integrative practice units (IPUs) to deliver value in health care, an idea championed by Michael Porter, PhD, a professor at Harvard Business School, Boston. Because they offer multidisciplinary care through a single setting, large urology group practices have in place many of the components of the IPU concept, which breaks down the silo of the traditional medical care delivery system.

    “Traditionally, a patient suspected to have prostate cancer would have a biopsy by a urologist at one practice, and the pathology review would be done elsewhere. The patient might then go for imaging at a hospital, and then see a radiation oncologist at yet another facility. Not only are these services occurring at sites that are geographically distinct, but the facilities may be on different electronic medical record, billing, and reporting systems that are not harmonized with each other. This siloed system creates room for duplication, waste, inefficiency, and error,” said Dr. Koo.

    “In an IPU, all of these services are available through an integrated setting. Large urology group practices follow that concept because they either have all of the services under one roof or at least they use one reporting system and the providers work with each other in a collaborative fashion. Because large urology group practices can render diagnosis and treatment efficiently and quickly, we have the infrastructure to best deliver value-based care.”

    Read: LUGPA puts resources behind key policy initiatives, future leaders

    Dr. Koo said that while the new payment system is looming on the horizon, few APM systems have been approved by CMMI, and those that exist are mostly for primary care.

    “The work falls onto urologists because nobody in CMS is working to develop urology-specific APMs, and that is entirely appropriate,” he said.

    Dr. Koo noted that the AUA has partnered with the American College of Surgeons to develop APMs. Those initiatives, however, are procedure-oriented and thus differ from LUGPA’s, which are based on outpatient/office-based disease state management.

    The process for developing an APM and getting it approved is very resource and time intensive, Dr. Koo said. It involves gathering best evidence based on current research and data that provides both clinical and financial support for the APM.

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