CMS made improvements for the Enhancing Oncology Model (EOM) over the Oncology Care Model (OCM), but there remains a delay in data and the challenge of high-cost, novel therapies, explained Stuart Staggs, vice president, Transformation and Shared Services, McKesson.
While CMS recently made adjustments to the Enhancing Oncology Model (EOM) to entice more practices to join, one thing that hasn’t been addressed yet is the high cost of treatments in oncology. Stuart Staggs, vice president, Transformation and Shared Services, McKesson, explained that when only a few practices have access to novel, expensive therapies, such as chimeric antigen receptor T-cell therapy, that haven’t been broadly adopted yet, there is the concern that these treatments are not being factored in appropriately and they are negatively impacting total cost of care.
He also discussed the delay in results, which had been a challenge in the Oncology Care Model (OCM), the predecessor to the EOM. However, he noted that there has been an improvement here over OCM. Now, CMS is releasing quarterly dashboards, which has more information than the old quarterly feedback reports, which had been more directional.
The challenge remaining is that not all of the information in the dashboard is attributed yet. “So, there might be some noise within that data that can be substantial, like some of those high-cost treatments still being in the cost of buckets for the patients that may be carved out later,” Staggs explained.
He joked that his analytics folks like to ask him, “Do you want the answer right now, or do you want it to be right?” Practices in EOM are getting good information right now compared with how it was under the OCM, but there are some delayed results still.
Finally, he outlined how The US Oncology Network is supporting its practices and all of the models they are taking part in through shared learnings in toolkits around depression, pain management, social needs, and advanced care planning.
“[We’re] trying to make sure that we're embracing everything we're learning from all these programs and putting [it] into those toolkits to say, ‘Here are the best practices we're seeing. Here are some of the best resources and information you can have for your patients and your care teams to do things differently,’” Staggs said.
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