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Oncology practices that participated in two-sided risk in the latter half of the Oncology Care Model (OCM) were the main driver of payment reductions in the model, according to an evaluation prepared for the Center for Medicare & Medicaid Innovation.
In February 2015, the Centers for Medicare & Medicaid Services (CMS) invited oncology physician group practices to participate in the OCM, an alternative payment model based on six-month episodes for cancer care for Medicare fee-for-service (FFS) beneficiaries undergoing chemotherapy treatment. The six-year OCM began with six-month chemotherapy treatment episodes, starting on July 1, 2016, and operated for 11 consecutive six-month performance periods (PPs). The last episodes ended on June 30, 2022.
OCM tested whether payment reform and healthcare delivery redesign can improve quality and reduce Medicare spending for patients undergoing chemotherapy for cancer, by combining attributes of medical homes—patient-centeredness, care coordination, accessibility, evidence-based guidelines, and continuous quality improvement—with financial incentives for providing services efficiently and with high quality.