Mike Fazio Discusses Opportunities for Change During the Delay Before Oncology Care First Begins

There are certain adjustments that CMS can make to Oncology Care First (OCF) during the delay that CMS is already doing successfully in other alternative payment models, said Mike Fazio, senior vice president of Client Services at Archway Health.

Transcript

Given the delayed start to Oncology Care First, where do you see opportunities for CMS to make changes to the model based on the ongoing challenges practices may have reported with the Oncology Care Model?

So, you know, we provided feedback back when they had an open period for comments, and I haven't seen anything come out of CMMI [Center for Medicare and Medicare Innovation] or CMS related to what changes they possibly could make to OCF. So, we've just been—as we communicate with CMS in both OCM [Oncology Care Model] and other programs—we've been trying to hit home adjustments that we'd like to see in the model that we hear from customers. But a lot of what we recommended were based on the other programs that they run, so specifically BPCI [Bundled Payments for Care Improvement] Advanced.

And so, a big one was the way that they created the regression model for OCM, which was really all cancer types. And so, what we see with BPCI Advanced is they look at each bundle individually and come up with pricing by bundle instead of the totality of all bundles that a program entails. And so those types of things, which really get into the pricing, is what we emphasized and said borrow what worked or is working in these other pilots. And that's what we expect to see with OCF. And we haven't seen details yet, if those things will be adjusted.

So, it sounded really good. You know, what we did take away from what CMS was indicating would be part of this new model. We haven't seen what that pricing model will be or how baseline or benchmarks will be created. And so, I guess those are big parts that we still need to see and hear. And we think that CMS is working on refining that and taking comments seriously. But I guess the proof will be once we get our hands on the pricing specs in the baseline data in benchmarks if they will be using for OCF.