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October 31, 2019

The Oncology Care Model—Why It Works and Why It Could Work Better: Accounting for Novel Therapies in Value-Based Payment

Author Affiliations
  • 1Tennessee Oncology, Nashville, Tennessee
  • 2OneOncology, Nashville, Tennessee
  • 3Tuple Health, Washington, DC
JAMA Oncol. 2020;6(8):1161-1162. doi:10.1001/jamaoncol.2019.4385

Value-based payment models (VBPMs) have become increasingly prevalent in oncology. The most robust example is the Oncology Care Model (OCM), a cancer-specific, 5-year experimental VBPM implemented by the Center for Medicare & Medicaid Innovation (CMMI). Medical oncologists participating in the OCM are held accountable for the total cost of 6-month episodes of care for patients with cancer receiving antineoplastic therapies. These costs are compared with target costs partially derived from historical cancer care spending measured during a baseline period spanning 2012 to 2015.1 This accountability, along with Monthly Enhanced Oncology Services (MEOS) payments, is intended to foster care coordination to reduce preventable emergency department visits, inpatient hospitalizations, and inpatient postacute care.

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