Dr Lalan Wilfong Highlights the Challenges of EOM Compared With OCM

The Enhancing Oncology Model (EOM), the successor of the Oncology Care Model (OCM), is not guaranteed to be a success based on some of the challenges and limitations facing participating practices, said Lalan Wilfong, MD, senior vice president of payer and care transformation at The US Oncology Network.

Several practices under The US Oncology Network umbrella are participating in the EOM.

COA has been outspoken in its criticism of the Center of Medicare and Medicaid Innovation. In what areas can the EOM improve to optimize keeping integrated value-based cancer care in the community and care costs down?

The Enhancing Oncology Model has a lot of good things about it and good things that they are trying to do, such as electronic patient-reported outcomes, and brought to light to social determinants of health and our need to screen and assist patients for that. There are criticisms for the EOM. Some of the main ones include the small MEOS [Monthly Enhanced Oncology Service] payments. It is very challenging to do the work that we need to do with the small amount of money that Medicare is giving us to fund those initiatives.

The small patient population, although it's good in one way that we're focusing on the patients that are at the highest risk, it hurts practices and their ability to have a wide breadth of patients so that we can provide services to all patients, not just those in the model. The other thing that I don't think people talk about as much is the impact on MIPS [Merit-based Incentive Payment System]. With the changing quality thresholds for MIPS, practices in the EOM will not meet thresholds to have success in MIPS with the model the way it is currently designed, which is a true limitation and puts a greatly increased burden on the practices for doing both programs.

Considering what you have seen so far about the EOM, is it indeed a successor model to the OCM?

EOM is definitely a successor to OCM. However, I don't think that means that it will be a success. There are many good qualities about the EOM like I described with the screening for social determinants of health and the focus on electronic patient-reported outcomes. It is challenging, though, to think that this will truly change the needle like OCM did in community oncology practices. Practices, because of the small payments, are going to be forced to only focus on those patients that are in the model. And it won't impart the same changes and all care management that the OCM was able to achieve.