Oncology Care Model

March 20, 2018

What is the CMS Oncology Care Model?

 The CMS Oncology Care Model (OCM) is an innovative, multi-payer model focused on providing higher quality, more coordinated oncology care.  Other payers are commercial insurers that will align their oncology payment models with Medicare’s model and support OCM practices in their practice transformation efforts.

 The Center for Medicare & Medicaid Innovation (CMS Innovation Center) is developing new payment and delivery models designed to improve the effectiveness and efficiency of specialty care. Among those specialty models is the Oncology Care Model, which aims to provide higher quality, more highly coordinated oncology care at the same or lower cost to Medicare.

How Does the OCM Impact Specialists?

Under the Oncology Care Model (OCM), physician practices have entered into payment arrangements that include financial and performance accountability for episodes of care surrounding chemotherapy administration to cancer patients. The Centers for Medicare and Medicaid Services (CMS) is also partnering with commercial payers in the model. The practices participating in OCM have committed to providing enhanced services to Medicare beneficiaries such as care coordination, navigation, and national treatment guidelines for care.*

How Does Integra Connect Help Oncology Practices with OCM?

Oncology Care Model practices already know – and peers will soon learn – that care management is essential to supporting their most at-risk patients in alignment with APM programs. Integra Connect offers the tools and services to equip care managers at oncology practices as they deploy these new value-based programs to patients:

  • Group and stratify at-risk patient populations requiring oncology care management interventions;
  • Capture and centralize program details, pathways, educational libraries, and other assets;
  • Enable care managers to work efficiently via a portal containing daily to-dos, patient-specific alerts, workflows, and tools to monitor and measure program participants;
  • Generate evidence-based care plans automatically based on pre-defined rules and custom parameters;
  • Deploy interventions, from new appointments to patient education and program enrollment.

*Source: https://innovation.cms.gov/initiatives/oncology-care/