Through the new IMH pilot, enrolled patients being treated at ICS will receive the free services of an ICS Nurse Care Manager (NCM), an oncology certified nurse whose primary purpose is to proactively address the challenging needs of oncology patients. The NCM will provide disease and treatment education, schedule phone calls after treatment, and closely follow symptom management issues. Subsequent meetings may include continued use of chemotherapy, advance care planning and hospice when appropriate. The ICS physicians will continue to assess these patients to develop and implement a plan of care that will attempt to actively address the patients’ needs during their treatments and beyond.

Some of the key aspects of the BCBSIL/ICS Oncology IMH model are:


Access to cancer care that is coordinated with the central focus on patients and their entire medical condition;
Cancer care that is optimized based on evidence-based medicine to produce quality outcomes;
Cancer care that is efficient, with treatment provided in a high-quality, low-cost setting for the patient;
Cancer care that is delivered in a patient-centric, caring environment that optimizes patient satisfaction; and
Cancer care that is continuously improved by measuring and benchmarking results against other facilities providing care, so that best practices “raise the bar” in delivering care.
“Providers with Illinois Cancer Specialists will enhance the quality of cancer care while controlling overall costs of care,” said Dr. Hakimian. “This will happen in a system where quality and value are measured and continuously improved.”

BCBSIL and ICS physicians will meet quarterly to exchange information and discuss if the IMH is a sustainable model for benefit and care delivery services. Some of the information discussed will include metrics on hospital admission rates, hospital days, ER visits, office visits and home health visits.

“The key to managing health costs is providing access to the right care in the right place,” said Dr. Hakimian. “This program with BCBSIL gives us valuable data that providers can use to improve the care our patients receive. This is a real opportunity for direct access to quality and cost data that will help inform decisions about how best to care for our patients. Blue Cross is making this level of transparency possible, something that wouldn’t otherwise be available to us.”

In traditional fee-for-service arrangements, reimbursement is based on specific services provided to patients; effectively rewarding providers for the volume of services they provide. In value-based care, provider reimbursement is associated with meeting quality or performance measures.

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