Oncology Care Model (OCM) are willing to take on two-sided risk

1
(No Transcript)
2
Oncology Care Model (OCM) are willing to take on
two-sided risk

• Oncology practitioners in CMSs Oncology care
  model (OCM) are willing to take on two-sided
  risk, according to the Community Oncology
  Alliance (COA) survey. The oncology practitioners
  are confident they can get success in providing
  quality and cost-effective cancer care as the
  healthcare system undergoes the shift from
  fee-for-service to value-based care.
• Community Oncology Alliance surveyed OCM
  participants following the CMMI (Center for
  Medicare Medicaid Innovation) December 3, 2019
  deadline, by which oncology practices had to
  decide whether to continue in the OCM program.
  Also, whether to enter into two-sided risk in the
  future. A total 68 Oncology Care Model practices
  participated in the 15 question survey which was
  published online between December 4, 2020, to
  December 20, 2020.
• Result of Survey
• 32 (47.1) Practices opted to remain in the OCM
  with one-sided risk
• 25 (36.8) practices opted to remain and enter
  into two-sided risk
• 22 of the 25 practices chose two-sided risk and
  had not received a single performance-based
  payment
• 11 (16) practices opted out from the OCM
• 10 out of 11 practices left the OCM had not
  received a performance-based payment over the
  preceding four performance periods

3
Oncology Care Model (OCM) are willing to take on
two-sided risk

• 1 practice received performance-based payment but
  opted out from the OCM
• COA had more than 80 percent of OCM participants
  networked in an interactive OCM support network
  that includes regular calls and meetings, a
  dedicated listserv, access to subject matter
  experts, and more. The purpose is to help
  participants involvement and success in OCM.
• Who are ready to take the two-sided risk?
• The COA survey were included questionnaire about
  the practices past OCM performance, its decision
  to continue or to withdraw from the program.
  Also, its decision regarding two-sided risk, and
  whether the practice obtained reinsurance. The
  practices which are continuing in the OCM and
  taking two-sided risk are representing 679 MDs.
  The average size of the practice that assuming
  the two-sided risk is 29.5 MDs. Almost 160 MDs of
  largest practices are taking the two-sided risk
  in the survey, and the smallest practice has two
  MDs.
• The opinion of COAs director

4
Oncology Care Model (OCM) are willing to take on
two-sided risk
As per COAs Director of strategic initiatives,
Bo Gamble, the survey result shows that
the oncology team has gained confidence with a
new model of cancer care. The last
three-and-a-half years have done much to educate
and prepare teams for new models for cancer
care, Mr. Gamble said. No longer are incentives
purely about utilization. Now there are numerous
attempts to design a model with an emphasis on
quality, value, and meaningful quantifiable
outcomes. The OCM, and the 20-plus other models,
are consistent with that message.   Oncology Care
Model The Oncology Care Model (OCM) is developed
by the Center for Medicare and Medicaid
Innovation, this is an episode-based payment
system. The multi-payer model is designed for
distinct instances of care, especially those who
are involving chemotherapy, which triggers the
six-month episode.   The program combines
fee-for-service (FFS) payments for established
services. It has monthly payments for additional
care under a structured guideline, and
performance-based payments weighed against
quality metrics and benchmarks.
5
Oncology Care Model (OCM) are willing to take on
two-sided risk
What Does the Future Hold for Oncology Practice
Transformation? The OCM has had a transformative
effect on community oncology practices but
implementation has been challenging, even for
practices with previous payment reform
experience. COAs efforts to support and advocate
for the OCM practices that have been struggling
with implementation eventually led COA to begin
developing its own payment model for cancer care
based on quality and value. It is an
alternative payment model, it includes bold
proposals for value-based drug contracts if
implemented. It would provide quality and managed
oncology care at the same or lower cost.