Community-based practices in The Network advance value-based care by significantly reducing costs while enhancing care.
Michael Seiden, MD, PhD
November 11, 2020 - The US Oncology Network (The Network) reached a major milestone recently in its journey to provide high-quality, value-based care to local communities by enrolling its 100,000th patient in the Centers for Medicare & Medicaid Innovation’s (CMMI) Oncology Care Model (OCM). In realizing this goal, the participating Network practices delivered more than $122 million in cumulative savings to Medicare over the program’s first six performance periods (PP). The OCM is a five-year pilot program developed by CMMI to provide higher quality, more coordinated cancer care at the same or lower cost to Medicare. The program is part of Medicare’s ongoing effort to move healthcare to a system based on value rather than volume.
“We are very excited to enroll our 100,000th patient in the Oncology Care Model while also providing over $100 million in cumulative savings to Medicare,” said Michael Seiden, MD, PhD, president, The US Oncology Network. “These achievements showcase the ability of practices in The Network to consistently perform well in the OCM while demonstrating that high-quality care and cost management can work in tandem to provide value to all stakeholders.”
The OCM is a very large, complex program that requires enhanced patient care, effective cost management and comprehensive clinical data reporting to Medicare, to highlight only a few key elements of the program. Practices across The Network are performing well in the OCM, and most have shown improvement for each subsequent performance period.
“Celebrating our 100,000th OCM patient and seeing better performance each period remind us that success is an ongoing process,” said Beatrice Mautner, vice president of Clinical & Innovent Services, The US Oncology Network. “We are continually striving to be at the forefront of value-based care by constantly developing innovative resources and solutions to challenges as they arise, empowering community oncology to lead the way forward and succeed in this new environment.”
At the end of the most recent OCM performance period, PP6, significant gains occurred in critical performance areas across the participating Network practices, resulting in:
✓ Improved quality compared to baseline performance during Performance Period 1
• Hospitalizations reduced by 7 percent • Emergency department visits decreased by 3 percent
• Hospice utilization increased by 5 percent
✓ Increased focus on pain and depression management
• The pain level of 94 percent of patients was captured and a plan implemented for elevated pain control
• 80 percent of patients who reported depression were screened and given strategies for improvement
✓ Enhanced patient experience and services
• Shared decision making with patients became a priority at the start of treatment
• Patients received a comprehensive treatment plan explained by the physician
• Access to care was improved with “Call Us First” campaigns, proactive high-risk outreach, enhanced triage, electronic patient-reported outcomes and same day/next morning urgent care access
• Increased support and care coordination were provided through highly trained navigators and social workers
“The impressive results achieved by The Network is a testament to the commitment by the practices to deliver highquality, value-based care,” said Marcus Neubauer, MD, chief medical officer, The US Oncology Network. “Enrolling 100,000 patients into the OCM and earning high performance marks during PP6 are proof that the participating Network practices are major contributors to this program by providing quality care and saving healthcare dollars.”
Although many practices participating in the OCM are still looking for a path to success, those in The Network have succeeded in part because they have access to comprehensive, proven resources that have helped them successfully transition to value-based care. These resources include industry-leading technologies that drive evidence-based decision-making at the point of care, advanced analytics for optimal data management and reporting, and innovative pharmacy solutions for efficient drug management. The Network, supported by McKesson, also provides practices access to thought leaders and key staff who have deep expertise in the OCM and value-based care.
“At least 50 percent of The Network practices participating in the OCM have chosen two-sided risk for 2020,” noted Stuart Staggs, senior director of Strategic Programs, McKesson. “This demonstrates a very high level of confidence in the support they are receiving from The Network and McKesson that enables them to successfully meet the complex challenges the OCM presents.”