HHS Announces New Oncology Care Management Initiative

A new Affordable Care Act initiative from HHS will better coordinate cancer care with the intention of improving the quality of care provided and reducing the money spent on healthcare, according to an announcement from HHS.

Cancer cost the United States an estimated $263.8 billion in medical costs and lost productivity in 2010, with the majority of patients who are diagnosed older than 65 years and Medicare beneficiaries. The Oncology Care Model was developed by the CMS Innovation Center through feedback from the oncology community, patient advocates, and the private sector.

“We aim to provide Medicare beneficiaries struggling with cancer with high-quality care around the clock and to reward doctors for the value, not volume, of care they provide. Improving the way we pay providers and deliver care to patients will result in healthier people,” Patrick Conway, MD, CMS chief medical officer and deputy administrator for innovation and quality, said in a statement.

CMS will invest in physician-led practices and allow them to innovate and delivery higher-quality care and is seeking participation of other payers. The model will provide episode-based, performance-based payments that incentivize high-quality, coordinated care. Practices that participate in the Oncology Care Model will receive monthly care management payments for each Medicare fee-for-service beneficiary during an episode.

The model will focus on 3 key areas: linking payment to quality of care; improving and innovating care delivery; and sharing information more broadly to providers, consumers, and others to support better decision while maintaining privacy.

“With the Oncology Care Model, CMS has the opportunity to achieve 3 goals in the care of this medically complex population who are facing a cancer diagnosis: better care, smarter spending, and healthier people,” Dr Conway said. “As a practicing physician and son of a Medicare beneficiary who died from cancer, I know the importance of well-coordinated care focused on the patient’s needs.”

More information about the Oncology Care Model will be available through a webinar from the CMS Innovation Center on February 19.