The Oncology Care Model (OCM) is a federal health reform program that aims to change the way cancer care in America is delivered. Its goal? To provide high quality, well-coordinated cancer care to patients while reducing costs for Medicare and beneficiaries. Eager to be involved in the future of cancer care, nearly 200 practices, treating more than 150,000 Medicare beneficiaries, joined when the Center for Medicare and Medicaid Innovation (CMMI) launched the OCM in the spring of 2016.
As a longtime coordinator of oncology payment reform and recognizing the importance of the program, the Community Oncology Alliance (COA) has been helping practices succeed in the OCM since day one. Today, close to 80% of the OCM participants are in a peer-to-peer network that is hosted by COA. The OCM support network was created at the request of our member community oncology practices. Through it, they have access to experts with deep knowledge of federal and private reform efforts, a private network of practices, regular calls to provide guidance on challenges, and numerous free tools and resources to help them thrive in the program.
COA is working with OCM practices to develop and share free tools and resources to help the practices manage implementation issues. We also seek to research and spotlight teams that demonstrate an exemplary job in certain areas of the OCM. These initiatives build upon the considerable work and resources COA has developed as part of its Oncology Medical Home (OMH) program, which is the foundation of the OCM.
At first, practices were enthusiastic about the OCM and its potential to improve quality while lowering costs. However, as the OCM has moved forward, the complexity, challenges, efforts and resources have grown in intensity.
The OCM has forced the cancer community to rethink how they are providing care and to make changes that enhance the patient experience and treatment. But the tremendous challenges of participating have left practices very concerned about its future as currently designed. From inefficiencies and technical challenges, to a lack of transparency and meaningful feedback, oncologists and practice administrators have numerous concerns–and have plenty of suggestions for its future.
COA is committed to making the OCM work but realizes that it has flaws, several fundamental in nature. Working closely to support practices in the OCM has allowed COA to recommend fixes to the OCM as well as plan how the model should evolve, including the revolutionary move of including value-based payments for drugs.
This work has led COA to develop a new framework for evolving the OCM model so that momentum started and knowledge gained is not lost and value-based care in oncology can continue to succeed. Known as the “OCM 2.0,” this new universal oncology payment model builds upon the OCM to provide a fundamental structure for the future, seeking to ensure that all Americans can have access to the highest quality cancer care at lower costs. The OCM 2.0 builds upon an extensive and detailed history of preceding value-based oncology payment models and efforts, beginning with the Oncology Medical Home (OMH) all the way to the ongoing OCM.
Read the full report here.