- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Dr Michael Kolodziej Discusses Taking on 2-Sided Risk in OCM After PP4 Results
Michael Kolodziej, MD, vice president and chief innovation officer at ADVI Health, Inc., discusses the move to 2-sided risk in the Oncology Care Model (OCM).
Michael Kolodziej, MD, vice president and chief innovation officer at ADVI Health, Inc., discusses the move to 2-sided risk in the Oncology Care Model (OCM).
Transcript
We're at a transformative time now with the OCM, with performance period 4 results out now with some practices having to either take on 2-sided risk or leave the model. What's the mindset of these practices right now?
You’d have to ask them. So, in general, I think physicians are risk averse. I think it’s pretty clear, and this is based on what [Center for Medicare and Medicaid Innovation] has told us, that a quarter of the practices aren’t close. Those guys are just going to quit. I think for the 35% or so of practices that are on the cusp, the question becomes if you do the math: I get the [Monthly Enhanced Oncology Services], I get the 5% bonus because of the advanced [alternative payment model], how far away am I and how can I manage that risk? And at least the scuttlebutt is that a lot of practices are engaging insurers to protect them from catastrophic loss.
So, they’re buying insurance against a bad outcome, which is not a bad idea because of the fact that we don’t know what therapies are going to come out in the next 5 years. We don’t know what the case mix is likely going to be in the next 5 years, and those are variables we cannot control. So even if you’ve done splendidly until this point, there’s still going to be risk going forward.
New Insights Into Meth-Associated PAH Care Gaps: Anjali Vaidya, MD, on Closing the Divide
June 4th 2025Research from Anjali Vaidya, MD, FACC, FASE, FACP, Temple University Hospital, reveals critical care gaps for patients with methamphetamine-associated pulmonary arterial hypertension (PAH), emphasizing the need for early diagnosis and integrated support.
Read More
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
The Role of Transplant in the Era of Novel MM Therapies: Harsh Parmar, MD
May 17th 2025Novel therapies for multiple myeloma (MM), including chimeric antigen receptor T-cell and bispecific antibodies, extend lives but raise concerns about treatment costs and adherence, and they haven't replaced stem cell transplantation, Harsh Parmar, MD, of Hackensack University Medical Center, explains.
Read More
Tailored Dosing for MM Matters More Than Drug Count: Ajai Chari, MD
April 25th 2025When it comes to treating multiple myeloma (MM), Ajai Chari, MD, argued that more is not always better. More intense treatment regimens, or those with more drugs, don't necessarily guarantee better outcomes.
Read More
