Dr Blase Polite Outlines the Decision to Move to 2-Sided Risk in the OCM

CMS is trying to make a 2-sided risk model in the Oncology Care Model enticing for practices, but there is still a lot of math practices need to work out before making the decision, said Blase Polite, MD, associate professor of medicine and the executive director for accountable care at the University of Chicago.

Transcript

Will the adjustments CMS has made for practices to take on 2-sided risk in the Oncology Care Model make a difference?

I think they are clearly trying to do everything possible to entice practices in and there have been very nice moves. I think there are more practices considering 2-sided risk than I would have predicted 2 or 3 years ago. So, I do think that they’re going to get a larger number than, again, I think they would have expected.

They’re trying to be as accommodating as possible because I know from their standpoint, having people who are interested in a 2-sided risk model is very, very important for them to be able to show that this is a feasible model going forward. So, they seem to be bending over backwards to get people enticed into the 2-sided risk model.

Our institute and others around the country are still running the numbers, there’s still al ittle bit of confusion of exactly how the math works out in the model, and what’s included in there. But, I think as people start running the numbers, to the extent that people will get the 5% bonus, the [Merit-based Incentive Payment System] bonus from being an advanced practice [alternative payment model], I think all those things make it more and more enticing to do a 2-sided risk model.

Now, on the other hand, there are those who do say, “Should we be rewarding CMS for a model that many consider flawed? And if by going into 2-sided risk, are we essentially voting with our approval, by doing 2-sided risk, that we’re happy with the model?” So, I know there is tension in the community on that side.

But they clearly are doing everything they can to get us into a 2-sided risk model.