Jeff Patton, MD, chief executive officer of Tennessee Oncology, discusses results from Oncology Care Model (OCM) performance period 3 (PP3) and challenges his practice still experiences with the model.
Jeff Patton, MD, CEO of Tennessee Oncology, discusses results from Oncology Care Model (OCM) performance period 3 (PP3) and challenges his practice still experiences with the model.
Transcript
With results from PP3 of the OCM now out, how did your results compare with PP2?
We have 4 pillars of trying to impact value in OCM; we do clinical pathways, we have nurse navigation, we have a triage platform, and we do palliative care. Through those, in each performance period, we’ve increased our savings. We’ve beat our benchmark every time, we’ve not hit the target, and so we haven’t had shared savings. But, every time, we’ve increased. PP3, we had 2.5% of savings. Now, if you remember, that includes the MEOS [Monthly Enhanced Oncology Services] payments, which is about 3%, so if you exclude the MEOS payments, we’ve saved 5.5% in the total cost of care. So, we’re excited about our results and going forward.
What are the most pressing challenges your practice still experiences with OCM and its reporting requirements?
You said it—the reporting requirements are probably the most onerous. We also think that risk stratification is not right and there’s some flaws there. And then the third and maybe the biggest is the novel therapy adjustment. If you’re an early adopter of a novel therapy, you get penalized. Even though there’s an adjustment, it’s an 80% adjustment, so by definition, you’re 20% in the hole with only an 80% adjustment. We think being penalized for being innovative is just not fair.
Latest Advances and Updates of Treatment in the Real World at AUA
May 1st 2024The annual meeting of the American Urological Association (AUA) not only presents the newest therapies coming out but showcases the latest in how treatments are being used in the real world, said Stephen Freedland, MD, of Cedars Sinai.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
AUA to Focus on Inclusive Care, Robotic Surgeries, and Future of Urology at 2024 Annual Meeting
May 1st 2024The American Urological Association (AUA) 2024 Annual Meeting will highlight the latest innovations and future trends in urology, featuring dynamic plenary sessions, educational opportunities for providers, and discussions on cutting-edge treatments and global health initiatives.
Read More
Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions
June 28th 2022On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.
Listen
Forging a Patient-Centric Path to Revolutionize and Redefine Value-Based Care
April 30th 2024Optum Life Sciences and Takeda Pharmaceuticals are partnering on an innovative virtual care pilot program for inflammatory bowel disease meant to both continue the mission of the current value-based health care landscape and raise the bar for personalized care delivery optimization.
Read More
Just as it is important for retail analysts to understand the choices their customers make and why they may choose not to purchase a specific item, so is it important for the specialty pharmacy industry to understand the actions of prescribers and how the often inefficient prior authorization process affects patient outcomes.
Read More