After a request for additional input from oncologists, practice administrators, payer representatives, and experts in physician payment and business analysis, ASCO has issued updated guidance on PCOP. With CMS’ Oncology Care Model set to end in 2021, the current draft of ASCO’s Community-based Oncology Medical Home model would be an option to take its place.
In 2014, the American Society of Clinical of Oncology (ASCO) released its first alternative payment model, Consolidated Payments for Oncology Care, aimed at reducing overall spending on cancer care (eg, by preventing unnecessary hospitalizations) and increasing revenue for oncologists. That original model also promised 10% raises to practices that scored high on quality-care measures, while those that fell short could be docked the same amount. ASCO promised limited financial risk under this model.1
That was followed in 2015 by the then-proposed Patient-Centered Oncology Payment (PCOP) model that promised a more flexible payment model to help oncology practices deliver the right care at the right price while holding the practices accountable for actually delivering that care.2
Now, after a request for additional input from oncologists, practice administrators, payer representatives, and experts in physician payment and business analysis, ASCO has issued updated guidance on PCOP. With CMS’ Oncology Care Model set to end in 2021, the current draft of ASCO’s Community-based Oncology Medical Home model would be an option to take its place, building on feedback from pilot programs and concerns that the first PCOP model was not specific enough.3 CMS has also proposed Oncology Care First to debut in 2021.
This new ASCO model “has requirements that practices have to follow in the way they deliver care, and this satisfies the concerns of payers,” said Jeffery Ward, MD, past chair of ASCO's Government Relations Committee and a contributor to PCOP. The update also has made clinical pathways a cornerstone of care delivery. ASCO hopes to deliver on the promises of PCOP using 3 approaches4: (1) improving the delivery and coordination of care, (2) developing a performance-based reimbursement system, (3) consistently delivering high-quality care.
"We're stewards of our patients' well-being, and ASCO's model reflects everything we have learned in over 50 years of work to advance patient care," ASCO President Howard A. "Skip" Burris III, MD, FACP, FASCO, stated.
ASCO projects PCOP could save up to 8% across the healthcare system.
1. Lowes R. New ASCO plan would boost oncologist revenue. Medscape website. medscape.com/viewarticle/824664. Published May 6, 2014. Accessed November 26, 2019.
2. Nelson R. ASCO unveils new model for oncology payments. Medscape website. medscape.com/viewarticle/845222. Published May 22, 2015. Accessed November 26, 2019.
3. Nelson R. ASCO updates its Patient-Centered Oncology Payment model. Medscape website. medscape.com/viewarticle/921820#vp_2. Published and accessed November 26, 2019.
4. ASCO. ASCO’s Patient-Centered Oncology Payment model (PCOP) supports higher quality, more affordable cancer care. ASCO website. practice.asco.org/billing-coding-reporting/macra-quality-payment-program/alternative-payment-models. Accessed November 26, 2019.