Community oncology practices are continuing to adapt to value-based reimbursement models as the Centers for Medicare and Medicaid Services (CMS) prepares to transition from the Oncology Care Model (OCM) to the Oncology Care First (OCF) model in 2022. While the full details of this transition are still pending, OCF is expected to include more practices than OCM – and may create similar challenges for oncologists and administrators when it comes to achieving financial performance.
Frost & Sullivan’s latest article, From OCM to OCF: Lessons Learned and What’s Next, recaps the key takeaways from a recent discussion among oncology practices that participated in OCM about preparing for the future of value-based care. Sponsored by Cardinal Health Specialty Solutions, the discussion highlighted the need for internal champions, data transparency, and additional staff to follow up with and triage patients who may be experiencing adverse events. Participating practice leaders also offered recommendations to community oncology practices that may be embarking on value-based reimbursement for the first time.
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“When it comes to succeeding in value-based care, it is essential for oncology practices to have a champion in an administrative role. This will ensure that the practice has a person who sees the whole picture, speaks the clinical language, and drives the overall operational change,” observed Patrick Riley, Healthcare & Life Sciences, Industry Principal at Frost & Sullivan. “It is also vital to add or assign staff to regularly follow up with patients and proactively address health issues before they lead to an ER visit.”
“To make the best use of their staff and resources and ensure that patients receive optimal care, practices are increasingly reliant on predictive data and analytics,” noted Amy Valley, Vice President, Clinical Strategy at Cardinal Health Specialty Solutions. “Artificial intelligence-enabled technology can be used to deliver actionable insights to help identify patients at high risk of mortality, ER visits, and hospital readmission, and provide them with early interventions. Data transparency will not only improve patient outcomes but also help practices achieve their financial targets.”
Community oncology practices need to prepare for the transition to OCF in 2022. After evaluating their current data trends, costs and care outcomes, practices should consider the following steps for a successful transition to this next value-based payment model:
- Be better prepared to take on more risks.
- Establish a baseline metric from current performance periods and then adjust as needed to address areas of opportunity.
- Invest in the resources and technology necessary to monitor and pivot to meet the demands of the evolving value-based care landscape.