Dr Stephen Grubbs on the Refresh of ASCO's PCOP Model
Stephen Grubbs, MD, vice president of clinical affairs at the American Society of Clinical Oncology, explains what stakeholders can expect from the new updates to the Patient-Centered Oncology Payment (PCOP) model, as well as some key differences between PCOP and the Oncology Care Model.
What are the most important differences between the Patient-Centered Oncology Payment [PCOP] model and the Oncology Care Model [OCM]?
So, PCOP is an alternative payment model [APM] that [the American Society of Clinical Oncology] ASCO published in May of 2015 after several years of work by our volunteers and staff. What’s interesting is the OCM, from CMS, was actually introduced the summer of 2015 and started in the summer of 2016, and there are many similarities between the 2 even though they were independently made.
So, over time, we’ve made some adjustments in the PCOP model that will be probably published this summer. We’ve taken some of the lessons learned from the OCM experience and other APMs in the oncology space and have actually refined our model some.
Initially, some of the differences were important to practices in that, the OCM was requiring total cost of care in considering the calculations of how well a practice was performing in it. The PCOP model initially said, “We probably should have our physician practices responsible for the total cost of care that they were controlling.” So, some issues about the cost of drugs became an issue and all that, so we’ve tried to adjust that in our new model.
The other thing that I think you’ll see different as we’ve refreshed our model, or are in the process of doing it, is we’ve taken a different approach because I think what we’ve learned is that not 1 sized model will fit everybody in the country and I think the OCM has [a] very sophisticated group of practices in it that we all know are really wonderful practices, but there’s a lot of practices out there that don’t have the resources of many of these practices. So, we’re kind of designing our refresh model so that many other types of practices can perform in the new model if someone wishes to take it up and use it.
One of the big differences is [that] we’ve kind of moved our model away from [the idea that] “across the country everybody should perform in this type of model,” to more of a regional based model because, again, care of medicine is local and you need to make adjustments for what your local community needs and wants so I think that’s where we’ve taken a little different [approach] is we’ve refined our model now.
The other part of our model that I think all the ones are beginning to recognize is you have to have a certain level of a care delivery system within your practices to make any of these things run properly, and therefore we’ve put a lot of thought process into what the practices will need to have in their infrastructure to be able to perform well in an APM.
Those are some of the differences and it’s still an evolution going on– OCM’s changed over the last several years too to the credit of CMMI so I think all these things from my perspective are experiments and they’re pilots and we need to learn from them. Not any 1 is by itself going to get the answer right the first time around.