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Implications of OCM Reports and the Future of the Program
October 29, 2018 – Laura Joszt
October 26, 2018
October 25, 2018 – Samantha DiGrande
October 24, 2018 – Jaime Rosenberg
October 23, 2018 – Samantha DiGrande
October 22, 2018 – Laura Joszt
October 21, 2018 – Laura Joszt
October 21, 2018 – Laura Joszt
October 20, 2018 – Samantha DiGrande
October 19, 2018 – David Bai, PharmD
Implications of OCM Reports and the Future of the Program
Laura Joszt
Lalan Wilfong, MD, moderated a conversation between Robert E. Baird, MD, CEO of Dayton Physicians Network, and Sarah Cevallos, chief revenue cycle officer for Florida Cancer Specialists and Research Institute, about current and future strategies for Oncology Care Model (OCM) participation, as well as key lessons from the OCM and how they can be applied in other reform models.
Practices participating in the Oncology Care Model (OCM) have now received results from 2 performance periods (PP). The first PP (PP1) results had shown that only 25% of practices achieved performance-based payments, while performance improved slightly in the second PP (PP2), with close to 30% of practices achieving performance-based payments, explained Lalan Wilfong, MD, vice president of quality programs at Texas Oncology.
On October 25, Wilfong sat down with Robert E. Baird, MD, CEO of Dayton Physicians Network, and Sarah Cevallos, chief revenue cycle officer for Florida Cancer Specialists, to discuss implications of the PP reports, as well as what they mean for the future.
Before joining the OCM, both practices had participated in other payer pilots, from which they gained experience with value-based payment models. According to Cevallos, getting involved with the OCM felt like “a natural transition,” but it remains “a work in progress every day.”
Baird explained that his practice wanted to be involved with the OCM after its experience with the COME Home project. It was during that project that his practice and its physicians understood that healthcare was really changing to more of a value-based model.
“We wanted to participate in OCM because we knew we wanted to be part of the solution and part of the transition and not just have things dictated towards us,” Baird explained.
Both Cevallos and Baird noted that participating in the OCM meant big changes in infrastructure and how care was delivered. Dayton Physicians Network implemented a nurse triage line and increased office hours, so patients have access to care on the weekends and late weekdays and don’t have to go to the emergency department or another site of care. Cevallos said that Florida Cancer Specialists made some of those same changes and also added hospitalists.
Communication about OCM remains a challenge. Baird and Cevallos both said that translating the requirements of the program to the practice and everyone involved has been one of the biggest hurdles. Both practices have implemented a lot of education and training for physicians and staff.
Cevallos said that “…you really need a dedicated team to make sure that they can translate the information to the clinical team and the operations team that’s not in it every day.” She added that some people have the ability to be on webinars in the middle of the day to learn about the program, but clinicians are busy with patients and need that information from the webinars explained to them later on.
They also discussed the results seen so far in the OCM. At the time of recording, practices had received PP1 and PP2 reports, which summarized spending and if costs of care were higher or lower than expected.
“The initial reconciliation reports were definitely shocking for us,” Cevallos admitted. Since then, Florida Cancer Specialists has made changes and seen positive results for PP2, but the reports are something that the practice is “still digesting and really trying to understand what to do next in terms of actionable items within the data.”
Baird agreed that the amount data can be overwhelming, and Dayton Physicians Network used an outside consultant to parse through the information to find areas of opportunity and areas of success. Baird added that his practice was also surprised with PP1 results. He called PP1 an “ah-ha” moment for most practices as they realized just how serious CMS was about the program, how much data it had, and that it could really measure practices’ performance to see how they improve quality and cost.
“That was a call to action,” Baird said. “That was when we really started to take some of the changes we needed to make seriously.”
On October 25, Wilfong sat down with Robert E. Baird, MD, CEO of Dayton Physicians Network, and Sarah Cevallos, chief revenue cycle officer for Florida Cancer Specialists, to discuss implications of the PP reports, as well as what they mean for the future.
Before joining the OCM, both practices had participated in other payer pilots, from which they gained experience with value-based payment models. According to Cevallos, getting involved with the OCM felt like “a natural transition,” but it remains “a work in progress every day.”
Baird explained that his practice wanted to be involved with the OCM after its experience with the COME Home project. It was during that project that his practice and its physicians understood that healthcare was really changing to more of a value-based model.
“We wanted to participate in OCM because we knew we wanted to be part of the solution and part of the transition and not just have things dictated towards us,” Baird explained.
Both Cevallos and Baird noted that participating in the OCM meant big changes in infrastructure and how care was delivered. Dayton Physicians Network implemented a nurse triage line and increased office hours, so patients have access to care on the weekends and late weekdays and don’t have to go to the emergency department or another site of care. Cevallos said that Florida Cancer Specialists made some of those same changes and also added hospitalists.
Communication about OCM remains a challenge. Baird and Cevallos both said that translating the requirements of the program to the practice and everyone involved has been one of the biggest hurdles. Both practices have implemented a lot of education and training for physicians and staff.
Cevallos said that “…you really need a dedicated team to make sure that they can translate the information to the clinical team and the operations team that’s not in it every day.” She added that some people have the ability to be on webinars in the middle of the day to learn about the program, but clinicians are busy with patients and need that information from the webinars explained to them later on.
They also discussed the results seen so far in the OCM. At the time of recording, practices had received PP1 and PP2 reports, which summarized spending and if costs of care were higher or lower than expected.
“The initial reconciliation reports were definitely shocking for us,” Cevallos admitted. Since then, Florida Cancer Specialists has made changes and seen positive results for PP2, but the reports are something that the practice is “still digesting and really trying to understand what to do next in terms of actionable items within the data.”
Baird agreed that the amount data can be overwhelming, and Dayton Physicians Network used an outside consultant to parse through the information to find areas of opportunity and areas of success. Baird added that his practice was also surprised with PP1 results. He called PP1 an “ah-ha” moment for most practices as they realized just how serious CMS was about the program, how much data it had, and that it could really measure practices’ performance to see how they improve quality and cost.
“That was a call to action,” Baird said. “That was when we really started to take some of the changes we needed to make seriously.”
