Early Findings From the Oncology Care Model Evaluation

Area of Science:

• Health services research
• Oncology
• Health economics

Background:

• The Oncology Care Model (OCM) is a CMS initiative designed as an alternative payment model for chemotherapy treatment.
• OCM focuses on 6-month chemotherapy treatment episodes to improve care coordination and value.
• Evaluating the OCM is crucial for understanding its impact on healthcare delivery and patient outcomes in oncology.

Purpose of the Study:

• To evaluate the Centers for Medicare & Medicaid Services (CMS)-sponsored Oncology Care Model (OCM).
• To summarize early findings on the OCM's impact on healthcare spending, utilization, quality of care, and patient experience.
• To assess the effects of the OCM during its initial performance period.

Main Methods:

• The OCM evaluation employed a difference-in-differences approach.
• Participating physician practices were compared to a propensity-matched group of nonparticipating practices.
• The study analyzed 6-month chemotherapy treatment episodes initiated between July 1, 2016, and January 1, 2017.

Main Results:

• No statistically significant impact on total episode payments was observed.
• Small but statistically significant declines were noted in intensive care unit (ICU) admissions and emergency department visits.
• Statistically significant reductions were found in inpatient hospitalizations and ICU admissions within 30 days of life.

Conclusions:

• Early OCM evaluation findings show modest impacts on specific acute care services with no change in total episode payments.
• The study highlights potential benefits in reducing acute care utilization and improving end-of-life care quality.
• Further research may be needed as practice redesign efforts evolve within the OCM framework.