CMS’s New Oncology Care Model Aims to Provide Better Care for Chemotherapy Patients

The Centers for Medicare and Medicaid (CMS) has developed the Oncology Care Model (OCM) to provide higher quality and more highly coordinated oncology care at the same or lower cost to Medicare. Specifically, the goal of OCM is to utilize financial incentives to enable improved care coordination, appropriateness of care and access to care for beneficiaries undergoing chemotherapy. The CMS Innovation Center expects these improvements will result in better care and smarter spending. According to CMS, “Practitioners in OCM are expected to rely on the most current medical evidence and shared decision-making with beneficiaries to inform their recommendation about whether a beneficiary should receive chemotherapy treatment.”

Fourteen commercial payers are participating in OCM, which includes a two-part payment system for these practices. These include a per-beneficiary Monthly Enhanced Oncology Services (MEOS) payment for the duration of the episode and the potential for a performance-based payment for episodes of chemotherapy care. The $160 MEOS payment assists practices in effectively managing and coordinating care for oncology patients during episodes of care, while the potential for performance-based payment incentivizes practices to lower the total cost of care and improve care for beneficiaries during treatment episodes.

In addition, the OCM model is working with electronic health records vendors to review data needs for OCM implementation and strategies to support practices in reporting data to the OCM Data Registry.