EOM Adjustments Make it Easier for Practices to Say “Yes” to Participation

When the Enhancing Oncology Model (EOM) kicked off in 2023, only 44 practices had joined, which was down significantly from the 122 practices in its predecessor, the Oncology Care Model. After taking feedback from practices, CMS opened the EOM back up for new practices to join and made some adjustments to make it easier for them to do so, said Stuart Staggs, vice president, Transformation and Shared Services, McKesson.

This transcript has been lightly edited for clarity.

Transcript

Can you explain some of the adjustments of the EOM that are being made now that practices have been in it for a while?

One big adjustment is they are opening it up again. So, they do want more to happen. Of course, and part of that is making adjustments to the model to make it easier to say “yes” to. One thing that will be happening in January is that one of the barriers to entry was upfront funding for the program, so the Monthly Enhancing Oncology Service payment, or MEOS, and they are going to increase that by $40 a month for episodes starting in January. Then secondly, they are reducing risk. Instead of being 98% of benchmark to avoid risk, you only have to be better than 100% of benchmark, which is a 2% give there. These changes are helping practices look at the model again and say, “Well if we didn't see a pathway into EOM, before we felt like there was too much risk or not enough upfront funding, there's more of an opportunity for you to get it now come January.”

We do have practices within our network that are looking at the model again. We have 12 practices that are in it now. This started back in 2023. Again, that's interesting. This never happened before. It didn't happen with the Oncology Care Model—they didn't open the door again once it was opened the first time. We're encouraged about that. We do think more practices will look at it and that some of those changes will also benefit existing practices that are in the model, starting again in January. To clarify those that do say “yes” now won't be able to start until July of next year, which will be that next performance period.

I think CMMI [Center for Medicare and Medicaid Innovation] is listening to feedback. Obviously, this is a big change because of that. I think we'll continue to learn more about what may need to change with the model as we see our first round of results come out in February. Of course, those results will true up a year later. So, we still won't have the final, final results until February 2026. But I think at that point, we'll be able to tell, really at a diagnosis level—are we seeing the right things? Are we seeing things we expect with the trend factors, the clinical adjustment, the experience adjuster, and also the novel therapy adjustment really being applied at the diagnosis level for the first time?