Oncology Stakeholders Summit, Spring 2015 - Episode 24

Concerns Surrounding Enrollment into the Oncology Care Model

Michael Kolodziej, MD, suggests that payer concerns about the overall structure of the Oncology Care Model caused CMS to delay its letter of intent deadline. In this segment, the managed care stakeholders discuss why payers may be hesitant to apply for enrollment into the program.

Together, Dr Kolodziej; Brian Kiss, MD; and Ted Okon, MBA, comment that the model has great potential to transform the overall delivery of patient care but is far too prescriptive. Mr Okon remarks that the CMS is attempting to “dictate medicine.” However, he adds that despite these far-reaching recommendations, some practices are simply refusing to change their processes.

A variety of performance-based measures need to be evaluated under the Oncology Care Model, notes Dr Kolodziej. Despite reporting on all these different measures, he suggests that there are additional concerns about whether or not a physician will be reimbursed.

Dr Kolodziej also remarks that the model is structured to eliminate practices that have not demonstrated shared savings after 3 years, even though it supposedly considers savings over a 5-year period. Dr Kolodziej and Mr Okon comment that it is difficult for practices to demonstrate savings and increase income within this relatively short time frame.