Dr Jeff Patton Discusses Preparing for OCM, Seeing Improved Outcomes and Savings

It’s very unusual to see significant cost savings in the first year of a program; that was true of all the pioneer ACO programs, said Jeff Patton, MD, CEO of Tennessee Oncology.

Transcript (slightly modified)

We have what we call the 4 pillars. We do pathways with the oncology pathways; we’ve built a triage platform on the sales force platform for nurse triage; we’ve partnered with Aspire, which is a palliative care company; and then we’ve hired care coordinators, and that’s probably the least defined of the 4 pillars because I’m not sure we know what the perfect way is. We know it’s important, but I’m not sure we’ve figured out how to make it work.

What steps have you taken to prepare your practice for OCM?

What’s the capital investment for implementing OCM, and how much time do you think it will take for a practice to see improved patient outcomes and cost savings?

It’s very unusual to see significant cost savings in the first year of a program; that was true of all the pioneer ACO programs. So, whether we’ll see more than 7% in the first year, we don’t know. That’s our math because the first 4% goes back to CMS, but then you have to pay back your MEOS payments, and that’s about 3% by our calculation. So, whether we’ll realize those type of savings, we don’t know. We do have feedback for the last 3 quarters; our ER visits have gone down and our hospitalizations have gone down, so we know we’re saving some money. But, we may be more than making up for those savings by adopting novel therapies. So that’s on the savings side.

On the investment side, I don’t have an exact number for you, but I’ve heard published data that it probably cost between, if you do everything right, $225-$250 per member per month, and we’re getting paid $160, so it’s a big investment. We’ve invested in the pathways, we’ve invested in the triage system, and then we’ve hired quite a few people, quite a few billers, abstracters, care coordinators. We’ve increased our number of medical assistants because they’re the ones entering most of the data. It’s a significant capital investment.