US Oncology Network, Tennessee Oncology Tout Medicare OCM Savings

Results from the Centers for Medicare and Medicaid Innovation (CMMI) report for the 8th performance period (PP8) of the Oncology Care Model (OCM) revealed that practices in the US Oncology Network and Tennessee Oncology that have participated in the program achieved high quality metrics and provided millions of dollars in savings to Medicare.

The OCM is a pilot program designed by CMMI to improve and better coordinate cancer care at the same or lower cost to Medicare. It is considered to be an integral part of Medicare’s ongoing effort to adopt a more value-based approach to health care.

The US Oncology Network

According to the report, all 14 of the participating practices within the Oncology Network improved patient care by achieving high quality measurement scores, resulting in a 100% Performance Multiplier for them. Combined, the practices saved Medicare about $54 million over the 6-month performance period to produce $197 million total savings since the OCM began in 2016, according to the organization.¹ These 14 practices represent approximately 1 fourth of all providers participating in the program.

“We are extremely proud of the exceptional performance of all 14 of the practices in The US Oncology Network participating in the OCM and the cost savings they delivered to Medicare,” said Stuart Staggs, senior director of Strategic Programs for the US Oncology Network, in a statement.

During PP8, the US Oncology Network saw the lowest observed patient emergency department (ED) use since the start of the program, largely due to practices providing patients in need of immediate attention enhanced services, including nurse navigation, enhanced triage, telehealth services, or urgent care visits within the clinic.

"It is reassuring to see how well The Network practices are performing, as the OCM is a bridge to the future and an important first step in creating patient-centered cancer care that focuses on both quality and value,” said Judi Payne, director of value-based care transformation for the US Oncology Network.

Tennessee Oncology

Between the second half of 2019 and the first half of 2020, Tennessee Oncology saved Medicare over $5 million in total spending, doubling to over $10 million when removing care management payments, which do not contribute to patient expenditures. “As the cost of cancer care rises and patient financial toxicity worsens, savings such as this is more important than ever,” the organization wrote in a statement.²

Additionally, Tennessee Oncology received a 100% quality score during this period. The quality score comprised of measurements of patients paid and depression assessment and management, patient experience, reduction in unnecessary ED visits, and patient-centered end of life care through appropriate hospice utilization. Tennessee Oncology saw a 20% reduction in hospitalizations and a 27% reduction in ED visits PP8.

“To accomplish these results, we invested heavily in data analytics, created care navigation touch points, and incorporated electronic patient reported outcome monitoring to improve patient care. It is exciting to see these efforts working to improve quality and reduce cost for our patients,” said Leah Owens, executive director of care transformation at Tennessee Oncology.

The organization also made investments in building a palliative care program to help patients with management of symptoms and psychosocial support. During PP8, Tennessee Oncology saw palliative care referrals increase over 17%.

“Palliative care is an important component of the cancer care journey and has been shown to improve quality of life and even extend life for patients with cancer,” said Sandhya Mudumbi, MD, medical director of palliative care at Tennessee Oncology.

“Transforming to value-based care is not easy and takes time….The recent OCM report suggests the model did not succeed; however, our experience shows that for practices that commit to high value care….For Tennessee Oncology, we are finally here and excited to be on the cutting edge of care delivery innovation to improve patient care,” said Natalie Dickson, MD, president and chief medical officer at Tennessee Oncology.

Reference

1. New metrics show the US Oncology Network practices leading the way in value-based care. News release. The US Oncology Network. November 16, 2021. Accessed November 19, 2021. https://usoncology.com/news/new-metrics-show-the-us-oncology-network-practices-leading-the-way-in-value-based-care/
2. Tennessee Oncology receives perfect quality score while saving Medicare $5 million during last year of Oncology Care Model. News release. Tennessee Oncology. Accessed November 19, 2021.