Evaluation of Practice Patterns Among Oncologists Participating in the Oncology Care Model

Area of Science:

• Oncology
• Health Economics
• Healthcare Policy

Background:

• Fee-for-service is a common reimbursement model for clinicians.
• Emergent shared-savings models are increasingly used, but evidence in oncology is limited.

Purpose of the Study:

• To analyze the early use and cost associations of the Oncology Care Model (OCM), a Medicare payment program with a shared-savings component.
• To evaluate the impact of the OCM on care utilization and costs for common cancers.

Main Methods:

• A nonrandomized controlled study utilized a difference-in-differences approach.
• Data from July 2015 to June 2017 (one year pre- and one year post-OCM launch) were analyzed.
• Care use and costs were compared between OCM-participating and nonparticipating practices for breast, lung, colon, and prostate cancers.

Main Results:

• OCM participation was associated with reduced drug use and costs for prostate and lung cancer treatments.
• Total costs for breast, lung, colon, and prostate cancer treatments were lower in OCM practices, but largely offset by program costs.
• Clinician visits decreased for breast and colon cancer patients in OCM practices.

Conclusions:

• Shared-savings payment models like the OCM may reduce healthcare utilization and costs in oncology.
• The first-year savings observed in the OCM were modest, considering the program's administrative expenses.
• Further research is needed to fully understand the long-term economic impact of such payment models in cancer care.