NORWALK, Conn., Dec. 16, 2019 /PRNewswire/ -- Today, an expert Work Group released a white paper outlining recommendations for the next iteration of the Centers for Medicare and Medicaid Services (CMS)' Oncology Care Model.
The Work Group – convened in November 2018 by Remedy, America's leading episodes-of-care company – was comprised of:
- Nick Bluhm, Senior Director, Strategy & Government Policy, Remedy
- François de Brantes, Senior Vice President, Business Development, Remedy
- Ezekiel J. Emanuel, M.D., Ph.D., Vice Provost for Global Initiatives, University of Pennsylvania
- Alice G. Gosfield, Esq., Principal, Alice G. Gosfield and Associates, P.C.
- Michael Kolodziej, M.D., Vice President and Chief Innovation Officer, ADVI Health
- Valinda Rutledge, Vice President, Federal Affairs, America's Physicians Group
The Oncology Care Model tests whether additional funding for enhanced services and financial incentives to improve the quality and appropriateness of care provided to Medicare Fee-For-Service (FFS) beneficiaries can improve quality and reduce Medicare spending for patients undergoing chemotherapy for cancer. The white paper outlines a set of five principles that the Work Group recommends to refine and enhance the model to achieve reduced toxicity, improved outcomes and moderated cost. The five principles include:
- Focus on Episodes with the most opportunity for care redesign, quality improvement and cost reduction;
- Use existing, payer-agnostic sets of clinical pathways;
- Clinicians should be responsible for only the care patterns they can control, but should have full accountability within those pathways;
- Overlap policy should ensure appropriate opportunity within each model; and
- Model evaluation is paramount to enable informed payment policy decisions.
"The recommendations released today address some of the shortcomings of the original Oncology Care Model design and adopt lessons learned from other successful value-based payment models," said François de Brantes, Senior Vice President of Business Development at Remedy. "The model is a bold experiment from CMS' Innovation Center, but if CMS takes these principles into consideration, it will help ensure the widespread adoption and spread of oncology care payment reform beyond traditional Medicare."
"Medicare pays for half of the two million Americans newly diagnosed with cancer each year, which is why we need payment reform that will drive improved patient outcomes and cost savings," said Alice Gosfield, Esq., Principal at Alice G. Gosfield and Associates, P.C. and Work Group member. "CMS' Oncology Care Model is a promising start to Medicare's payment reform for oncology care, but we hope that the recommendations in this paper will provide the necessary refinements that will ensure uptake by providers and improved outcomes for patients."
To download the white paper, click here
To learn more about these recommendations, read the Work Group's blog post in Health Affairs
Remedy is America's leading episodes-of-care company, which connects employers, insurance companies, and health care systems to deliver more cost-effective care and improved consumer experiences. Remedy delivers software and services enabling health care providers and health insurers to organize and finance health care around patient episodes of care. The Company's bundled payment network serves Medicare and private insurers and manages over $9 billion of annual health spending. In August 2019, Remedy merged with Signify Health. Signify has a large national network of mobile clinicians that provide complex care in the home and other settings. For more information, visit www.powerofremedy.com.