COA’s Dr Miriam Atkins: APMs Can’t Be One Size Fits All

Alternative payment models that treat all practices the same or don’t account for variations aren’t very fair, particularly to community oncology practices, said Miriam Atkins, MD, FACP, president of the Community Oncology Alliance (COA) and physician and partner of AO Multispecialty Clinic in Augusta, Georgia.

Atkins was just reelected to a second consecutive term as president.

Transcript

As COA president during the transition from OCM to the EOM, which started July 1, how do you envision leveraging your position to foster collaboration, resilience, and innovation within the community oncology sector?

As the president of COA, I don't think I can really leverage my position for that. The issue with OCM [Oncology Care Model] and EOM [Enhancing Oncology Model], one thing is, my practice was with OCM for a short period of time, and we ended up getting out of it because we had physicians with different tax ID numbers, and that's not qualified [so we had] to get out for that.

But [another] issue is, we had to hire extra staff for the information that [CMS] wanted, and we're already short on staff. So, given the little staff, we had more responsibilities. And the other issue is, we get the MEOS [Monthly Enhanced Oncology Services] payment or a payment, and then [CMS] decides, well, “you didn't meet the criteria, so we're going to take it back.” That's very frustrating, and it doesn't leave us much confidence in how fair this will actually be to community practices.

How can we hope to innovate for the future if at present, practices can’t agree on a suitable alternative payment model to keep community oncology care affordable, reimbursable, and within the community?

One big issue would be to make the reimbursement fair. As long as the hospital can get paid 2 or 3 times more than I can, it's going to make it harder to keep my doors open. The other issue about the payment models is every practice is different, and every state is different. So, it's not one size fits all.