CMS Announces OHC Selected for Initiative Promoting Better Cancer Care

CINCINNATI, July 11, 2016 /PRNewswire-iReach/ -- The Centers for Medicare & Medicaid Services (CMS) recently announced that it has selected OHC as one of nearly 200 physician group practices across the country and 17 health insurance companies to participate in a care delivery model that supports and encourages higher quality, value driven, and more coordinated cancer care.  The Medicare arm of the Oncology Care Model includes more than 3,200 oncologists and will cover approximately 155,000 Medicare beneficiaries nationwide.

"We are delighted to be selected for the Medicare Oncology Care Model as it aligns with our strategic commitment to be at the forefront of participating in value-based care models that improve care for our patients," said E. Randolph Broun, M.D., President and Chairman of the Board at OHC. "This delivery care model will help us improve our patient education, population health management, pshycosocial support, medication adherence and other patient navigation activities."

In addition to the CMS Oncology Care Model, OHC also participates in other care delivery pilot programs including UnitedHealthcare Episodes of Care, Aetna Oncology Medical Home, Humana Oncology Model of Care, Mercy Health Select ACO and treatment pathway programs with Anthem and Humana. OHC is also a committed partner to the Health Care Payment Learning and Action Network, with goals of obtaining 90% of payments tied to quality and value.

Cancer is one of the most common and devastating diseases in the United States: more than 1.6 million new cases of cancer will be diagnosed and cancer will kill an estimated 600,000 Americans in 2016. According to the National Institutes of Health, based on growth and aging of the U.S. population, medical expenditures for cancer in the year 2020 are projected to reach at least $158 billion (in 2010 dollars) – an increase of 27 percent over 2010. A significant proportion of those diagnosed are over 65 years old and Medicare beneficiaries.

"The Oncology Care Model encourages greater collaboration, information sharing, and care coordination, so that patients get the care they need, when they need it," said Health and Human Services Secretary Sylvia M. Burwell. "This patient-centered care model fits within the Administration's dual missions for delivery system reform and the White House Cancer Moonshot Task Force – to improve patient access to and the quality of health care while spending dollars more wisely."

The Oncology Care Model encourages practices to improve care and lower costs through episode- and performance-based payments that reward high-quality patient care. The Oncology Care Model is one of the first CMS physician-led specialty care models and builds on lessons learned from other innovative programs and private-sector models. As part of this model, physician practices may receive performance-based payments for episodes of care surrounding chemotherapy administration to Medicare patients with cancer, as well as a monthly care management payment for each beneficiary. The two-sided risk track of this model would be an Advanced Alternative Payment Model under the newly proposed Quality Payment Program, which would implement provisions from the Medicare Access and CHIP Reauthorization Act of 2015.

Practices participating in the five-year Oncology Care Model will provide treatment following nationally recognized clinical guidelines for beneficiaries undergoing chemotherapy, with an emphasis on person-centered care. They will provide enhanced services to beneficiaries who are in the Oncology Care Model to help them receive timely, coordinated treatment. These services may include:

·      Coordinating appointments with providers within and outside the oncology practice to ensure timely delivery of diagnostic and treatment services;

·      Providing 24/7 access to care when needed;

·      Arranging for diagnostic scans and follow up with other members of the medical team such as surgeons, radiation oncologists, and other specialists that support the beneficiary through their cancer treatment;

·      Making sure that data from scans, blood test results, and other tests are received in advance of patient appointments so that patients do not need to schedule additional visits; and

·      Providing access to additional patient resources such as emotional support groups, pain management services, and clinical trials.

"CMS is thrilled with how many physician groups chose to be a part of the Oncology Care Model," said Patrick Conway, M.D., CMS principal deputy administrator and chief medical officer. "We have nearly doubled the number of participants that we anticipated. It's clear that oncology physicians recognize the importance of this new performance-based, episode-based payment approach to cancer care. As a practicing physician and son of a Medicare beneficiary who died from cancer, I know the importance of well-coordinated care focused on the patient's needs."

The names of those practices and payers participating in the Oncology Care Model, and more information about the model, can be found on the model's website: http://innovation.cms.gov/initiatives/Oncology-Care/. The Oncology Care Model begins on July 1, 2016 and runs through June 30, 2021.

As part of the Administration's "better care, smarter spending, healthier people" approach to improving health delivery, the Oncology Care Model is one of many innovative payment and care delivery models developed by the CMS Innovation Center and advanced by the Affordable Care Act. The Innovation Center is committed to transforming the Medicare, Medicaid and Children's Health Insurance Program (CHIP) programs and is expected to help deliver better care for individuals, better health for populations, and lower growth in expenditures for Medicare, Medicaid and CHIP beneficiaries.

Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter @CMSgov

About OHC

For more than 30 years, OHC has remained the region's premier provider of treatments for adult cancer and complex blood disorders, offering a wide range of services, state-of-the-art treatments and leading edge technologies. As the only nationally accredited oncology medical home in Cincinnati, Ohio, OHC puts patients first by delivering leading edge, compassionate, and convenient care, tailored to meet a patient's medical and personal needs.

OHC offers nationally recognized clinical trials to help achieve groundbreaking advancements in the treatment of cancer and the most experienced adult blood and marrow transplant center in tri-state. With neighborhood locations throughout the tri-state area, OHC is one of the largest independent oncology practices in the United States.

Media Contact: Kristin Deuber, Kristin Mack Deuber, LLC, (614) 975-4186, [email protected]

News distributed by PR Newswire iReach: https://ireach.prnewswire.com

SOURCE Centers for Medicare & Medicaid Services (CMS)