Community-based practices enhanced care while significantly reducing costs
THE WOODLANDS, Texas, Oct. 8, 2019 — The Centers for Medicare & Medicaid Innovation (CMMI) recently released results for the fourth performance period of the Oncology Care Model (OCM), and all 15 practices in The US Oncology Network (The Network) participating in the program earned high marks for quality performance. While improving care and providing an enhanced patient experience, the practices saved Medicare approximately $35 million during the performance period compared to the established benchmark. The OCM is a five-year pilot program put forth by CMMI designed to provide higher quality, more coordinated cancer care at the same or lower cost to Medicare. Scheduled to sunset in June 2021, it is an integral part of Medicare’s ongoing effort to transition healthcare to a system based on value over volume.
“The exceptional quality performance of practices in The Network participating in the OCM as well as the cost savings they delivered to Medicare and its beneficiaries provide evidence that practices can maintain high-quality care while providing value ―a main goal of the OCM,” said Marcus Neubauer, MD, chief medical officer, The US Oncology Network. “Not only are these practices meeting the basic requirements of this complex yet important model, but they are generally showing improvement each subsequent performance period. After conquering the initial learning curve, practices in The Network are finding ways to thrive in this program along the continuum of enhanced patient care, managing costs, and reporting clinical data to Medicare.”
The US Oncology Network is committed to ensuring that community practices have access to all of the resources necessary to successfully accomplish the massive practice transformation required by the OCM and other value-based alternative payment models. A wide range of comprehensive, proven resources are available to drive best practices, such as industry-leading technologies that support decision-making at the point of care, advanced analytics for optimal data management and reporting, and innovative pharmacy solutions that provide better drug management. As industry leaders in value-based care, The Network, supported by McKesson, also gives practices access to thought leaders and key staff who have deep expertise in the field. Additionally, with more than 940 physicians in The Network participating in the OCM, there are many opportunities to share challenges and solutions with colleagues, providing a strong support system as practices transition to a whole new way of doing business.
“The OCM is a very large, complex program that requires total practice transformation in order to perform well,” explained Lalan Wilfong, MD, VP of Value-Based Care and Quality Programs for Texas Oncology, a practice in The US Oncology Network participating in the OCM. “The program is a bridge to the future, so it is essential for us to learn how to thrive in this model. The requirements can be quite overwhelming, but thanks to the support and guidance from highly knowledgeable experts in The Network and McKesson, we have a roadmap for success. They have devoted a tremendous amount of time, effort and resources to ensure participating practices do well in the program, and we greatly appreciate that commitment to us.”
As the end of the year approaches, practices in the OCM must decide if they want to participate in a more challenging two-sided risk arrangement in the model with a significant downside (payback) potential. This is a difficult decision for community-based practices, as there is much at stake, and this is not a decision they have previously had to make. Practices in The Network have a distinct advantage in the decision-making process since The Network is providing the data and expertise they need to make the most appropriate choice tailored to their practice. Given the performance levels achieved through the fourth OCM performance period, most of The Network practices participating are expected to move forward with the program plus accept the two-sided risk arrangement.
The practices in The US Oncology Network are making a significant contribution to the success of the OCM, enrolling more than 26,000 patients every performance period. By demonstrating substantial savings for Medicare and its beneficiaries while enhancing patient care and the patient experience, The Network is living up to the ideals of the program and providing proof that high-quality care and cost management are not mutually exclusive.
“The US Oncology Network is strongly committed to the Oncology Care Model and practice transformation to enhance high-quality patient care,” noted Dr. Neubauer. “We are proud to be part of this groundbreaking program that is redefining the delivery of cancer care and the way in which it is reimbursed.”
About The US Oncology Network
Every day, The US Oncology Network (The Network) helps more than 1,200 independent physicians deliver value-based, integrated care to patients — close to home. Through The Network, these independent doctors come together to form a community of shared expertise and resources dedicated to advancing local cancer care and to delivering better patient outcomes. The Network provides practices with access to coordinated resources, best business practices, and the experience, infrastructure and support of McKesson Corporation. This collaboration allows the providers in The Network to focus on the health of their patients, while McKesson focuses on the health of their practices. The Network is committed to the success of independent practices, everywhere.