Dr Basit Chaudhry Outlines Findings From OCM PP3

April 7, 2019

Results from performance period 3 (PP3) were somewhat concerning because the amount of practices that achieved a shared savings stayed stable from PP2, explained Basit Chaudhry, MD, PhD, founder of Tuple Health.

Results from performance period 3 (PP3) were somewhat concerning because the amount of practices that achieved a shared savings stayed stable from PP2, explained Basit Chaudhry, MD, PhD, founder of Tuple Health.

Transcript

With results from OCM performance period 3 now out, did you see improvement over performance periods 2 and 1?

It’s interesting. In PP3, 33% of practices were able to achieve a shared savings. I think that was somewhat concerning because that’s stayed stable since PP2. So, in PP2, there was also 33% of practices that achieved a savings. In PP1, it had been 25%. So, between PP1 and PP2, we saw a growth or improvement. I personally was hoping that we’d continue to see aggregate improvement in performance in terms of achieving a shared savings. That unfortunately didn’t happen, so that aspect of performance leveled out.

The other thing that was important about the results that we saw from PP3 is that we’ve gotten additional data on what’s happened in the true-up period. So, true-ups are roughly, Medicare claims can be sent in about a year after a service is provided. So, in performance-based models, you continue to look at what happens as claims roll out or into Medicare. So, for PP1, the number of practices that retained a shared savings went from 25% to 20%. For PP2, it went from 33% to 25%. So, there’s kind of 2 trends I think that are concerning with the results of shared savings. One is we’ve leveled out in terms of the proportion of practices that have achieved a shared savings, and then the true-up process, we’re seeing a regression of the results.

Now, from what we understand from Medicare, different practices are getting shared savings at different times. So, overall from what they’ve said is that from the start of the program, around 50% of all the participants have achieved at least 1 shared savings. So, I feel like that’s progress in certain respects, but in aggregate, I think there’s still concerns over where practices are. The other thing I think is sort of how do you look at performance versus the benchmark. So, the benchmark doesn’t take into account the amount that’s provided from the MEOS [Monthly Enhanced Oncology Services] payments or the 4% discount, which is supposed to neutralize that. So, practices are doing better with respect to the benchmark; about three quarters of practices, from what we understand, are under benchmark. But, there’s still a concern there on how people are doing with respect to performance-based payments, and what this means is the upshot of it is that if practices are going to stay in OCM, a good proportion most likely would need to go to a down-sided risk model.