November 05, 2019
The Centers for Medicare and Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) held a public listening session on Monday, November 4, 2019, to discuss a new oncology payment model that builds on the current Oncology Care Model (OCM). CMS is calling this new model the Oncology Care First Model (OCF). The OCM is scheduled to end on June 30, 2021. CMS is proposing the OCF as a voluntary, five-year, multi-payer model that would run from January 2021 to December 2025.
As currently proposed the OCF would include both physician group practices and hospital outpatient departments that provide oncology care. The model would hold participants accountable for the total cost of care (including drug costs and adjusted for quality and cost relative to the benchmark and target amounts) and they would receive a performance-based payment (e.g. two-sided risk). Participants would also receive a steady stream of revenue through a monthly population payment. The Innovation Center is accepting feedback on an informal request for information (RFI) on this potential new model until November 25, 2019. Written comments can be sent to OCF@cms.hhs.gov.
At the public listening session, CMS solicited feedback on how to best improve the quality of care for cancer patients, potential payment methodologies, and risk arrangements. In her opening remarks, CMS Administrator Seem Verma reiterated the agency’s commitment to value-based care and reminded the audience that it was a bi-partisan priority that pre-dates the Trump Administration. She indicated that currently the Innovation Center is focused on implementing more models and working on meeting goals such as the release of real-time data to help model participants better understand their performance in a timely manner, improvements to interoperability to enhance care coordination, and the reduction of the administrative burden of participating in these models to allow providers to focus on patient care.
During the public listening session stakeholders provided a range of feedback to CMS. Highlights of the comments are below.
More information about the model can be found on the CMS OCF website.
For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at firstname.lastname@example.org or Mara McDermott at email@example.com.