David Ortiz Discusses Making Adjustments, Reacting to Performance Period Reports in OCM

The long time between when a performance period ends and when the report comes out in the Oncology Care Model (OCM) can make it difficult to measure the impact specific changes are making, said David Ortiz, OCM program director at Montefiore Einstein Center for Cancer Care.

What differences have you seen from performance period to performance period under the Oncology Care Model?
I think the first time we started, we started late in the program, so we didn’t see any performance gains in the first performance period. But the second and third were great opportunities. I think that we’ve been able to successfully incrementally show some savings that benefit the program. I think what’s also been gained by that is that everybody is paying attention. So, now they see some benefit in the success of that effort. Now they’re all wanting and prepared to contribute. I think they didn’t know what it was all about and I think just performing and reaching those milestones—being one of the 30% in the second performance period, being one in I think it’s 30% again, being able to consistently do that from performance period to performance period that’s been a great benefit to us.

How difficult is it to make adjustments under the OCM given how much time can go by between when a performance period ends and when practices get the results of the performance period?
It’s made it a little bit of challenge, right? Because everything is retrospective and there’s no way—all throughout our attempts we’ve really tried to figure out the most proactive way of doing our forecast and how do we measure with this? It’s hard to also know that what changes we’re making now, what lasting effect it is later. So, I think that always has been the challenge with the program in terms of how it reports out.

But one thing, though, is that we’re constantly looking not just at one effort and waiting to see, we’re constantly looking at every opportunity. [Emergency department] utilization, overall usage in terms of hospice care. These are items that our feedback reports have been what keep us focused on what incremental changes we should make and can make.
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