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Aetna official urges oncologists to avoid variability

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In this interview, Michael Kolodziej, M.D., argues that in managing cancer care “variation almost never yields a superior result”. He urges clinicians to stick to optimized practices.

Dr. Kolodziej is the national medical director for  oncology solutions, Office of the Chief Medical Officer, at Aetna, the huge insurance company,

He says of variability in treatment: “I think it may come partially from a belief that the doctor is always right. I think we train doctors to be individualistic. Being willing to embrace the idea that you really ought to look at how you’re doing things and think about ways to make them better — that’s not a place where many doctors feel comfortable.”

As for payment for physicians:

“You {the physician} bill me for the enhanced clinical services and then we reconcile at the end of year when we compare your performance with the market competition. We don’t compare your performance on how you did last year. Because if you’re already doing really well, it’s hard to improve much more.

“I think what’s going to happen — and this is my hope and my projection — that by having enough of these relationships, we’re going to be able to get an idea of how much better these practices are and then we should be able to determine a management fee. And ultimately, the information that we’re going to get from this will allow us to figure out what an episode should look like and cost because we will have clinical details. This program will help us figure out the components that go in and stay out of an episode. That is my vision of where this goes.”



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