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Community Oncology Alliance (COA) Payer Exchange Summit 2018

Dr Kavita Patel Explains How the OCM Has Evolved

We've noticed that all of these transformation activities– care transformation, quality improvement, are all actually working, explained Kavita Patel, MD, MS, non-resident senior fellow at the Brookings Institution.


We've noticed that all of these transformation activities– care transformation, quality improvement, are all actually working, explained Kavita Patel, MD, MS, non-resident senior fellow at the Brookings Institution.

Transcript:

How has the Oncology Care Model (OCM) evolved? What do you think it does well, and what are some of the pain points that participanting practices continue to face?

So, the OCM has evolved in a couple of interesting ways. Data is now a very regular, kind of term with the OCM practices. Almost all of them have done something with the access to claims data that they have, so that’s actually progress. 

The second thing that they’ve all noticed is that these transformation activities– care transformation, quality improvement, are all actually working. Not necessarily the way they might have thought, but they’re making patients feel like they’re getting better care and, in some cases, they’re delivering on improvements in quality measures.

The thing that’s not working as well is still this kind of clunkiness with things like attribution. It takes a long time– there’s a lag in how CMS processes the data about attribution and what we call reconciliation. It might take doctors up to [about] 18 months to ultimately know if the patient they thought they were taking care of is actually acknowledged by Medicare as their patient, and then vice versa. People that they thought were their patients are not necessarily theirs and they don’t find out until about a year later. So, there’s still some clunky things that have to do with how Medicare just processes claims under the model.

 
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