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The Oncology Care Model: Improving Patient Outcomes and Lowering Costs

May 6, 2022

Oncology care is one of the most progressive medical fields to be a part of. There are constant innovations that help to improve patient outcomes and reduce mortality rates. One of the most promising developments has been the oncology care model (OCM). This new method of providing patient care can revolutionize the way oncology centers are run.

What Is the OCM Model?

The oncology care model is a new cancer care delivery model first implemented in 2015. This model provides a unique style of patient care experience. Instead of encouraging providers to focus on fee-based services and constantly increase patient volume, the OCM promotes value-based oncology care.

Healthcare practices are required to follow six fundamental guidelines to qualify as an OCM clinic:

  • Give patients an easy and convenient way to navigate healthcare resources
  • Ensure patients can access a qualified clinician who has access to their medical records at all times
  • Offer oncology treatment that meets all recognized care guidelines
  • Create a 13-point care plan for each patient
  • Document care with electronic health records certified by the Office of the National Coordinator for Health Information Technology
  • Monitor and regularly assess data to find ways to enhance care quality

To compensate providers for the shift away from a fee-based structure, OCM offers financial incentives. The Centers for Medicare & Medicaid Services (CMS) provide discounts based on clinic performance. Providers are evaluated for performance, and CMS adjusts savings based on how well they perform. These financial incentives and reimbursements ensure providers who offer quality care don’t lose money.

The Benefits of OCM

The OCM’s primary goal is to address inefficiencies in the U.S. healthcare system. It aims to pivot care away from the fee-for-service model. Instead of encouraging providers to offer a wide range of disorganized services at various fees, OCM focuses on value-based oncology care. This strategy allows for a more targeted approach to patients’ healthcare needs. The patient-centered culture of OCM can reduce the stress and challenges associated with cancer care.

OCM also aims to address the financial inequalities in cancer care. OCM techniques empower patients to learn about potential costs and make the right choices for their financial situation. The increased financial counseling results in more affordable care for patients and fewer unnecessary expenses for healthcare facilities.

Another advantage of OCM is that it changes the way patients’ healthcare is managed. Patients get early access to care and more convenient options for urgent care. This can help people manage their symptoms proactively instead of waiting until emergency department visits are necessary. Providers can also offer more helpful patient experiences like early palliative care.

Does OCM Improve Patient Outcomes and Provider Satisfaction?

When the OCM pilot program was first launched, over 400 oncology practices signed up to participate in a five-year evaluation. So far, the results have been promising with both patients and oncology facilities reporting positive results.

Surveys have shown that patient satisfaction rates are higher with the OCM. People reported that they felt more in control of their treatment and had less stressful patient experiences. Those who used the OCM also had more referrals to appropriate specialists and more care for their mental health needs. Patients who did and didn’t use OCM had similar survival rates. However, the quality of life was higher for end-stage patients under OCM.

Most providers have also reported satisfaction with the OCM methods. There were initially concerns that providers who switched to value-based programs would lose money compared to their fee-based competitors. So far, this hasn’t been the case because the financial incentives from the government have covered any gap. However, CMS has not yet confirmed how incentives will change once the pilot program ends in June 2022.

What to Expect at Facilities That Use the OCM Model

Oncology care model facilities implement some unique practices not found at other providers. When patients choose to work with OCM providers, they can expect a more thorough intake process. Providers carefully assess the patient’s medical records and create a care plan that works for their needs. Patients also take more time learning about treatment options and discussing their preferences.

Throughout their patient care experience, people can expect reliable support from their care team. Instead of being shuffled between uninformed doctors, patients work with the same essential support team the whole time. As they get assistance from other specialists and clinicians, they can be confident that each new person is fully-updated on their unique needs. Ultimately, value-based programs help reduce some of the stress and confusion associated with oncology care.

About Verdi Oncology

Verdi Oncology empowers physicians in our network to focus on exceptional patient care where continuous improvement and growth are shared priorities. We understand the challenges facing oncology practices and have the tools and expertise to help practices achieve sustainable growth. With the help of members of our network, we’re improving cancer treatment for patients and their families.