A one-size-fits-all approach to alternative payment models (APMs) often isn’t very fair to community practices, said Miriam Atkins, MD, FACP, president of the Community Oncology Alliance.
Alternative payment models that treat all practices the same or don’t account for variations aren’t very fair, particularly to community oncology practices, said Miriam Atkins, MD, FACP, president of the Community Oncology Alliance (COA) and physician and partner of AO Multispecialty Clinic in Augusta, Georgia.
Atkins was just reelected to a second consecutive term as president.
Transcript
As COA president during the transition from OCM to the EOM, which started July 1, how do you envision leveraging your position to foster collaboration, resilience, and innovation within the community oncology sector?
As the president of COA, I don't think I can really leverage my position for that. The issue with OCM [Oncology Care Model] and EOM [Enhancing Oncology Model], one thing is, my practice was with OCM for a short period of time, and we ended up getting out of it because we had physicians with different tax ID numbers, and that's not qualified [so we had] to get out for that.
But [another] issue is, we had to hire extra staff for the information that [CMS] wanted, and we're already short on staff. So, given the little staff, we had more responsibilities. And the other issue is, we get the MEOS [Monthly Enhanced Oncology Services] payment or a payment, and then [CMS] decides, well, “you didn't meet the criteria, so we're going to take it back.” That's very frustrating, and it doesn't leave us much confidence in how fair this will actually be to community practices.
How can we hope to innovate for the future if at present, practices can’t agree on a suitable alternative payment model to keep community oncology care affordable, reimbursable, and within the community?
One big issue would be to make the reimbursement fair. As long as the hospital can get paid 2 or 3 times more than I can, it's going to make it harder to keep my doors open. The other issue about the payment models is every practice is different, and every state is different. So, it's not one size fits all.
CMS' 340B Repayment Proposal May Harm Vulnerable Hospitals, Reward Those With Higher Revenues
April 26th 2024The 340B hospitals not receiving an offsetting lump-sum payment from CMS following 2018-2022 cuts later ruled unlawful are disproportionately rural, publicly owned, and nonacademic, according to a new study.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Empowering Community Health Through Wellness and Faith
April 23rd 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In the third episode, Camille Clarke-Smith, EdD, MS, CHES, CPT, discusses approaching community health holistically through spiritual and community engagement.
Listen