Highmark Health is rethinking how it pays cancer doctors to encourage those who provide more effective care, part of a plan to reward quality over quantity in oncology, the insurer said Tuesday. “We’re aligning those incentives. Providers really do want to do the right thing. But in a fee-for-service environment, the reward is about doing more,â€? said Dr. Ginny Calega, vice president of medical management and policy at Downtown-based Highmark. The company said it will gauge how well oncologists follow standard protocols in a pilot program at Allegheny Health Network, the seven-hospital network that Highmark formed in 2013. Highmark has yet to determine total cost savings from the approach, which should translate to lighter out-of-pocket expenses for its insurance customers, Calega said. She listed the reimbursement changes among several efforts to streamline and strengthen the network’s cancer care over the next several months, though Highmark didn’t supply a timeline. The company competes with UPMC, the largest hospital system in Western Pennsylvania. “We’ve been working silently — and we haven’t been talking to anybody about this — to do this type of thing for several years,â€? said Dr. Peter G. Ellis, associate chief medical officer at UPMC CancerCenter. He said UPMC has pursued for years the ideas emerging at Highmark, including an expansion of cancer care into more suburban and rural clinics around Pittsburgh. “We like to brag that there’s no place that’s more than 10 or 15 minutes away from a UPMC cancer center in all of Western Pennsylvania,â€? Ellis said. “Access to care is vitally important, especially given that most of the people who get this disease are older.â€? Still, Calega said, Highmark stands apart with an integrated approach. Starting Wednesday, some Allegheny Health Network patients with Highmark insurance can receive second-opinion consultations from Johns Hopkins Medicine for rare and complex cancer cases at no additional cost. The option will reach more Highmark customers by January. The company said it plans to renegotiate contracts to drive down cancer drug costs and to offer less fragmented care across more locations, including patients’ homes. Calega said Highmark wants to build a model for efficiency that it can use in other regions, including Delaware and West Virginia. Highmark insures about 118,500 cancer patients, though it didn’t identify how many live in Western Pennsylvania or receive Allegheny Health Network care. At the Allegheny County Medical Society, Executive Director John Krah said his organization of about 3,000 physicians will watch for specifics. Some clinician advocacy groups argue it’s tough to assess how much care is necessary for any patient. “The focus today is on treating patients, to the extent possible, on an outpatient basis,â€? Krah said. “It’s very expensive to provide care in a hospital, and most patients, frankly, would rather be cared for as outpatients or in their home.â€? Adam Smeltz is a Trib Total Media staff writer. Reach him at 412-380-5676 or asmeltz@tribweb.com. Email Newsletters TribLIVE's Daily and Weekly email newsletters deliver the news you want and information you need, right to your inbox.