Lessons Learned from the Oncology Care Model

Stephanie GingerOncology Care Model

It probably comes as no surprise that the Oncology Care Model is still a hot topic among cancer care providers. This was underscored by the significant interest in a recent session at the ACCC National Oncology Conference in Orlando. The session prompted many questions that are likely familiar to care teams watching the value-based care landscape evolve:

  • Are you considering two-sided risk?
  • How do you track the number of avoided ED visits?
  • Did you add nursing or other staff to monitor patient symptoms?
  • How does the distress assessment trigger intervention?

These tactical questions illustrate how the audience is wrestling with the challenges of value-based care programs like OCM, and that they are wondering how the added requirements and resources can be tracked and handled in a sustainable way.

Sameer Mahesh, MD, Director for Hematology-Oncology for Summa Health Medical Group-Hematology/Oncology, Summa Cancer Institute and Nina Chavez, MBA, FACMPE, Chief Operating Officer for New Mexico Oncology Hematology Consultants shared their experiences as OCM participants such what changes they made at their practice and their key takeaways.

Both practices had to make changes to the care they provided, including extended hours, accommodating same-day visits, utilizing triage pathways, and adding resources like palliative care. These changes have produced good results. Interestingly, since NMOHC was already a participant in value programs like COME HOME, it was more difficult for that practice to receive the performance payment from OCM. This is because NMOHC was compared to their own past costs, which were already lower than many practices. And while both practices received a performance payment in the fourth period, neither are considering two-sided risk.

The speakers also shared some key takeaways including:

  • Stakeholders must understand the new alternative payment model and what it means for them and they way they deliver care
  • Drugs account for 50% of expenditures and hospital admissions account for 20% of expenditures – think about small, positive steps to reduce these to have a large impact
  • Healthcare professionals by nature are competitive, so sharing data in a constructive and transparent way can encourage change

At Navigating Cancer, we are also considering the challenges practices are facing and working to develop technology-based solutions. Our Patient Relationship Management platform enables swift and thorough symptom management, helps practice maximize it resources with streamlined workflows and automation and makes detailed, structured data available so practices can continuously improve and identify areas to gain additional efficiencies. Interested in learning more about PRM technology? Contact us today!