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CMS model for oncology care encourages value over volume
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CMS announced the release of its new Oncology Care Model — a multi-payer payment and care delivery model — intended to reward value of cancer care over volume of care.
Under the new model, beneficiaries undergoing cancer treatment would benefit from 24-hour access to practitioners, as well as from a focus on patient-centered care.
“Based on feedback from the medical, consumer and business communities, we are launching this new model of care to support clinicians’ work with their patients,” Patrick Conway, MD, CMS chief medical officer and deputy administrator for innovation and quality, said in a press release. “We aim to provide Medicare beneficiaries struggling with cancer with high-quality care around the clock and to reward doctors for the value, not volume, of care they provide. Improving the way we pay providers and deliver care to patients will result in healthier people.”
The model incorporates episode- and performance-based payments to provide a financial incentive for high-quality, lower-cost care, according to the release. In order to support comprehensive and coordinated patient care, practices that participate in the initiative also will receive monthly care management payments for each Medicare fee-for-service beneficiary.
Physician group practices and solo practitioners who deliver cancer chemotherapy — as well as commercial insurers, Medicare Advantage plans, stage programs and Medicaid managed care plan payers — may apply to participate in the care model.
“With the Oncology Care Model, CMS has the opportunity to achieve three goals in the care of this medically complex population who are facing a cancer diagnosis: better care, smarter spending and healthier people,” Conway said.
ASCO released a statement that commended CMS’s efforts to create a new physician payment system. However, the society also expressed concerns about the continuation of a fee-for-service system that still exists within the model.
“We are disappointed that they have chosen to pursue only one model — and one that continues to rely on a broken fee-for-service system,” Richard Schilsky, MD, FACP, FASCO, chief medical officer of ASCO, said in a press release. “ASCO looks forward to working with both public and private payers to explore new payment strategies that better reflect modern oncology practice and support high value, patient-centered care.”