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CMS announces new Oncology
Care Model

The U.S. Department of Health and Human Services announced last week a new multi-payer payment and care delivery model that would support better care coordination for cancer care in the United States. Nationwide, more than 1.6 million people are diagnosed with cancer each year—the majority being over the age of 65 and Medicare beneficiaries—and according to the National Institutes of Health, it is estimated that the United States incurred $263.8 billion in medical costs and lost productivity in 2010.

Explained in the Centers for Medicare & Medicaid Services’ (CMS) Feb. 12 news release, the Oncology Care Model encourages participating practices to improve care and lower costs through episode-based, performance-based payments that financially incentivize high-quality, coordinated care. Participating practices also will receive monthly care management payments for each Medicare fee-for-service beneficiary during an episode to support oncology practice transformation, including the provision of comprehensive, coordinated patient care.

“Based on the 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 the 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 the volume, of care they provide. Improving the way we pay providers and deliver care to patients will result in healthier people.”

Group and solo practices that provide chemotherapy for cancer patients and are currently enrolled in Medicare, as well as commercial payers, Medicare Advantage plans, state programs and Medicaid managed care plans, are encouraged to apply. Interested practices should submit letters of intent through the Oncology Care Model inbox by 5 p.m. (EDT) on April 23. The deadline for payers to submit their letters of intent is 5 p.m. (EDT) March 19.

Those that submit timely letters of intent will receive an authenticated web link and password to submit an electronic application. The applications are due June 18 at 5 p.m. (EDT).

Back to February 19, 2015 Medigram