OneOncology Practices Apply for Enhancing Oncology Model
OneOncology, which supports 15 community oncology practices through group purchasing, operational optimization, practice growth, and clinical innovation, says that all of its partner practices have applied to participate in Medicare’s Enhancing Oncology Model (EOM), the agency’s latest value-based care model for oncology.
One practice that has just partnered with Nashville-based OneOncology is North Carolina-based Oncology Specialists of Charlotte (OSC). OneOncology said it would leverage its value-based care expertise to assist OSC in participating in Medicare's EOM and other risk-bearing agreements with North Carolina-based commercial insurers.
"Joining the OneOncology platform benefits our patients, physicians and the entire Charlotte community," said Justin Favaro, M.D., president of OSC, in a statement. "OSC will be able to expand access to innovative treatment options, have a growing list of clinical trials, and be able to utilize resources from 14 other independent cancer practices across the country."
EOM is a voluntary model that will run for five years, from July 2023 through June 2028. Model participants will include oncology practices that treat people with Medicare undergoing chemotherapy for breast cancer, chronic leukemia, lung cancer, lymphoma, multiple myeloma, prostate cancer, and small intestine/colorectal cancer.
Participating providers will also provide enhanced services such as patient navigation, care planning, collection of electronic patient-reported outcomes (ePROs), and screening for social needs that may affect treatment, such as transportation issues and nutritional needs. EOM will also encourage other payers to align with its core concepts to promote a consistent approach across payers and EOM participants’ patient population.
EOM implements a two-part payment structure for EOM participants to incentivize the provision of Enhanced Services while creating incentives to reduce avoidable costs and utilization and improve care quality. EOM participants will be responsible for the total cost of care during a 6-month episode. Depending on total episode expenditures and quality performance, EOM participants have the potential to earn a performance-based payment (PBP) or owe CMS a performance-based recoupment (PBR). PBP and PBR amounts will be adjusted based on actual quality performance.
“With large and diverse patient populations combined with OneOncology’s analytics and value-based care expertise, our practice partners will have the data and insights to help them successfully participate in the EOM,” said Davey Daniel, M.D., chief medical officer of OneOncology, in a statement. “We’re proud that all OneOncology practices have applied to participate, and we look forward to working with them to them to drive high-quality, patient-centered outcomes in Medicare’s value-based oncology model.”
One of the key components of EOM is its emphasis on promoting health equity in cancer care. Daniel added: “Having 14 of 14 OneOncology practices apply for EOM is an important indication of our practice partners’ commitment to promote health equity. It also underscores the important contribution of the oncology community to improve access to high-quality cancer care for underserved populations.”
OneOncology said it has made significant investments in infrastructure and analytics to support practice partners in preparation for EOM participation. Additionally, clinical support via Disease Groups, Pathways, and Clinical Research will unlock differentiated solutions that will improve the quality of care for patients, improve the patient experience, and bolster OneOncology practices’ success in EOM. EOM participation will set a common foundation that aligns with OneOncology’s desired expansion of value-based care, and we look forward to helping our practices excel in this transition.
The company points out that EOM poses certain challenges for groups relative to Medicare’s prior value-based oncology model, OCM, such as increased investments needed to support additional reporting requirements, lower payments for enhanced oncology services, and mandatory downside risk.
“Throughout OCM, CMMI demonstrated its willingness to improve its payment models over time,” said Daniel. “For example, CMMI made important updates to OCM risk adjustment methodology and modification of risk arrangements in response to the COVID-19 pandemic. So, we remain optimistic about opportunities to engage CMMI to promote to EOM that will make the program more conducive to community oncology practices’ participation.”
