Administrators Say OCM Monthly Payments Won't Cover Costs of Improved Care

Meir Rinde
Published: Tuesday, Jun 27, 2017
Alti Rahman

Alti Rahman, MHA, MBA, CSSBB

Practices in CMS’ Oncology Care Model (OCM) are individually receiving hundreds of thousands of dollars in new annual revenue, but physicians and administrators are not exactly celebrating the influx of cash. The OCM requires substantial, ongoing spending on additional staff, software upgrades, and other infrastructure that has left some practices financially underwater on the model despite the new payments. Even those that are doing better must contend with the fact that the new funding counts toward their patients’ total cost of care. That total cost must be reduced if providers want to avoid being expelled from the program or possibly hit with financial penalties.

 

Table: How CMS Will Calculate Bonus Payment in the Oncology Care Model

Table: How CMS Will Calculate Bonus Payment in the Oncology Care Model

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