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On November 1, 2019, the Centers for Medicare & Medicaid Services (CMS) Innovation Center released details of a proposed alternative payment model for medical oncology care, called Oncology Care First (OCF), for public comment.1 The OCF model will succeed the Oncology Care Model (OCM), which will expire at the end of 2020. When it started in 2016, the OCM, which was voluntary, was important in oncology due to its emphasis on value-based care transformation.
The OCM requires practices to implement the following care transformation activities for patients receiving systemic cancer treatment: (1) 24/7 patient access to a clinician who can view the medical record; (2) patient navigation services; (3) documentation of a care plan that contains all components of the National Academy of Medicine’s Care Management Plan; (4) delivery of guideline-recommended care; (5) use of a federally certified electronic health record system; and (6) use of data for continuous quality improvement. There are currently 140 participating practices, which represents about 10% of US oncology practices. Because some of the largest multisite community and academic networks in the country are included, this represents about 25% of patients receiving systemic cancer treatment in the United States.
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Basch E, Wilfong L, Schrag D. Adding Patient-Reported Outcomes to Medicare’s Oncology Value-Based Payment Model. JAMA. Published online January 02, 2020. doi:10.1001/jama.2019.19970
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