CMS Working on a New Oncology Payment Model

CMS provided COA a draft of an episode-based payment model being developed at their Innovation Center. COA has been in collaboration with CMS on developing this model.

CMS sent the following email to COA President Dr. Bruce Gould, Immediate Past President Dr. Mark Thompson, and other stakeholders who participated in providing input on oncology payment reform.

Thank you for your engagement in the ongoing development of Center for Medicare and Medicaid Innovation (Innovation Center) payment and service delivery models. As we previously announced, the Innovation Center is interested in developing specialty practitioner-focused payment and delivery models that would be designed to improve the effectiveness and efficiency of specialty care. Among the specialty practitioner-focused models under development, the Innovation Center is developing an oncology care, episode-based model.

We understand that there is a high level of interest in an oncology model, and appreciate the significant input that we received from the oncology community to guide our development of the model’s framework. The Innovation Center has not finalized an oncology model or any of particular aspects of the model. However, given the level of interest in an oncology model test, we wanted to share the provisional design elements of the model. The attached design paper provides an explanation of target oncology patients and providers, as well as the anticipated structure of the payments. If CMS decides to move forward with an oncology model, the Innovation Center will publish the final model with additional detail regarding participation in the model, and will post a Request for Applications on the Innovation Center website.Link to the press release: Community Oncology Alliance

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