The OCM Involves A Lot of Guesswork

OncLive Chairman,

Mike Hennessy

The Oncology Care Model (OCM) blew into town this month, rattling the shutters and bringing with it a lot of dust. CMS has been locked up tight about this program for the past year—looking to protect itself and also move carefully as it launches this very impactful initiative to control medical spending and improve patient outcomes. Some say that restraint has impeded the flow of information that would have helped practices to prepare for the OCM.

The Community Oncology Alliance leapt into action on behalf of its membership, recruiting the services of a few seasoned veterans of government healthcare programs who could interpret the language of CMS and flesh out the details for dozens of the 196 independent practices, hospitals, and academic centers that had enrolled in the OCM. Many of these participants felt the natural confusion and trepidation inherent in joining a value initiative that practice administrators say remains a work-in-progress.

It’s not something that CMS would readily admit. However, Kelly Price, vice president and chief of healthcare data analytics for DataGen, notes that whatever the shortcomings of the OCM may be, there is evidence that CMS is capable of absorbing feedback from the physician community and incorporating that into program revisions. You can read about her thoughts on this transition in our feature on the OCM launch.

Oncology practice administrators were eager to talk about this program and stated that, despite the difficulty and the uncertainty of racing off into the unknown of a broad array of new measurement metrics and a new payment formula, they are for the most part committed to being in the OCM so that they can understand and influence what is likely to be the future of government structured, value-driven oncology care. Their tone was not complete resignation to an overwhelming change; it was more of an acknowledgement that this is a well-intentioned program that still resembles, in many ways, a large block of unsculpted clay. Practices themselves have a 90-day shakedown cruise starting July 1, during which they will be under relaxed standards for achieving goals. The “fun” begins later when CMS begins to raise the stakes for those involved.

That said, practice administrators said the OCM has required investment in new personnel and technology, and they’re not sure that the money will be recouped. They’re also not sure how well they can succeed with the 6-month episode payment formula, given that many new variables of patient care will be incorporated into the performance metrics. Some administrators said that the task of bringing patients up to speed on this model—and gaining their acceptance of it—appears to be a job that CMS has left up to the practices themselves. What they would like to see is that CMS does more of the public relations work.

Read all about the launch of the OCM in this month’s issue of Oncology Business Management, and check out our other stories, as well: rural physician recruitment, news from the 2016 ASCO Annual Meeting, defensive medicine, and our monthly practice profile are just some of our features this month. Good reading!