Rani Khetarpal Details Early Thoughts on the Oncology Care First Model

While it is too early to provide insight into whether or not the OCF model will be successful, I think its preliminary ideas are a step in the right direction, said Rani Khetarpal, MBA, vice president of Oncology Value-Based Partnerships at New Century Health.

Transcipt

What are your early thoughts on the request for information of the Oncology Care First Model?

So, I think number 1 is that CMMI [Center for Medicare and Medicaid Innovation] has delivered on their promise of coming up with another model to back up OCM [Oncology Care Model]. They did say that it was going to be a 2-sided risk model, so they stayed true to that. I think there’s a lot that still needs to be discussed and worked out; we’ve only had it for a week. So, today is November 8, this was released on Friday of last week, so just preliminary looking at it, reading through it, and listening to different perspectives at the feedback session, I think there are components of it that are very similar to OCM. They did listen to a couple of different things—I think the biggest buckets that are different is number 1, the MPP [monthly population payment] prospective payment versus the MEOS [monthly enhanced oncology services] payment. One of the questions we have is how is that going to be calculated? Because practices are going to have to rely on that in lieu of fee-for-service payment, and a MEOS payment on top of that, to make sure all of their costs are covered–not only for their actual day-to-day care of the patient, but also for any sort of resources they have to invest in to actually meet the parameters of the model. So, that’s probably 1 of the biggest question marks on people’s minds is how is that payment going to be actually adjudicated and what is the number?

I think there’s still some very complicated formulas involved in the pricing methodology, and I think the word transparency comes to mind of it can be more transparent and we hope that they would be a lot more transparent with how the pricing methodology is determined—that can still be yet to come. I think interestingly enough, the 2 tracks for risk–I like that idea, because there are practices that may have a higher risk tolerance and are able and willing to take that on, and are predicted to have more success in that; but for those practices that don’t fit that high risk model, there is another track you can take. I think that there needs to be some consideration for practices that have dropped out of the model in forcing them into a 2-sided model when they’ve dropped from the model for whatever reason–2 sided risk wasn’t the right way to go or they didn’t have the resources to invest in the model–I don’t think it’s fair for them to jump into a 2-sided risk model. So, I think there needs to be some consideration given to that as well.

Overall, I think it’s a step in the right direction. I think there are still some things that need to be looked at. I for 1 feel that the way that they have structured it similar to OCM I think is a good thing because you’re not reinventing the wheel, you’re just sort of hopefully improving on it and I'm hoping, and I’m hopeful that—I know the intent of CMMI is to ensure that this model is better than the first iteration of OCM and that more practices are willing to take on that 2-sided risk in making it more attractive for those practices. So, that’s the end result–we’ll see what happens. It’s very very early so once the commenting is done and the actual proposed rule becomes final, I’ll have a lot more insight into whether or not this will be successful for practices.