Oncology Care Model (OCM) – Six Years Later
By Lalan Wilfong, MD, SVP, Payer & Care Transformation and Stuart Staggs, Sr. Director, Strategic Programs
After six years of dedicated effort to deliver high-quality care at a more sustainable cost, we’re pleased to share final Oncology Care Model (OCM) results from practices in The US Oncology Network (The Network). The practices’ dedication to value-based case resulted in an improved experience and better outcomes for ~130,000 unique Medicare patients. Since 2016, Medicare OCM patients treated in these practices in The Network realized a 37% reduction in inpatient stays, 18% decrease in emergency room visits, and a 6% increase in access to hospice >3 days before end of life.
Care teams in The Network improved access to patient services; specifically navigation, social work, nutrition, financial counseling, survivorship, advance care planning, and palliative care to ensure patients receive the right care at the right time. Treatment plan adoption led to more targeted shared decision-making conversations to help ensure patients are aware of what to expect throughout treatment and anticipated outcomes. Drug initiatives, with biosimilar conversion at the helm, made it possible to bend the total cost curve while remaining focused on evidence-based outcomes. Even as COVID impacted everyone during the latter half of the OCM, practices continued to make great strides on improving quality while enabling patient access to essential care and support services.
And practices in The Network proved that quality oncology care can be delivered while also bending the total cost curve. Over the life of the OCM, practices in The Network saved Medicare $337M compared to the benchmark amount. More than half of practices in The Network participating in the OCM were confident enough in their efforts to voluntarily pursue two-sided risk. This is a testament to the practices’ leadership and commitment to value-based care, and to their partnership with The Network, which aims to instill confidence in practice and care transformation. The momentum from the OCM contributed to a marked increase in value-based care (VBC) initiatives, and we now have over 70 different VBC commercial programs across The Network.
We are looking ahead to the Enhancing Oncology Model (EOM), the successor to the OCM, that will launch in July 2023 – and we’re working hard to ensure that practices in The Network are equipped with the knowledge, processes, analytics and technology to be successful in this program.
Lalan Wilfong, MD
Senior Vice President, Payer and Care Transformation
Senior Director, Strategic Programs