Dr Basit Chaudhry Weighs the Challenges of a 6-Month Episode Under OCM

May 21, 2019

While there are consequences of a 6-month episode of care under the Oncology Care Model (OCM), there will be trade-offs with any time window, explained Basit Chaudhry, MD, PhD, founder of Tuple Health.

While there are consequences of a 6-month episode of care under the Oncology Care Model (OCM), there will be trade-offs with any time window, explained Basit Chaudhry, MD, PhD, founder of Tuple Health.

Transcript

Are there any consequences of 6-month episodes of care under the Oncology Care Model?

One of the interesting things that’s happening substantively in terms of oncology itself and in terms of cancer, which has been a good thing to see, is that in many ways, cancers are fortunately taking on dimensions almost of chronic diseases. Patients are living with them much longer. This does create challenges on how to build a subspecialty payment model. So, there’s a lot of reasons why 6 months makes sense for an episode of care, but there’s also limitations to it. Just as an extreme example, say patients with myeloma. Fortunately, they’re living years with the disease. So, in looking at a 6-month snapshot, you really only get a snapshot; you’re not really getting the total picture of what’s happening in the course of the disease, which again, is a small miracle because this isn’t the way cancer was before.

So, it’s a relief and a great blessing for us as a society that this is now the case. But again, this does create challenges on how do you build a value-based subspecialty model, in turn, because you have to pick some time period if you want to do an episode-based model, and all of them have different trade-offs involved with it. So, I do think this is something we’ve been working on and thinking through in terms of in the future as we evolve value-based payment in oncology, what’s the right time frame, what’s the right trigger, when should you start looking at the services delivered, and related issues. I think there’s just going to be different trade-offs involved with the time window that you look at for these kinds of models.

Is there a better alternative to the 6-month episode?

I think that in terms of better, it’s a little difficult to say, because I think there’s just different trade-offs involved with the time windows that you look at. So, a lot of this is related to what are goals and objectives, what is the policy trying to create, what are you trying to structure, what are you trying to support or facilitate? For instance, are you trying to develop consistency of access to care and provider relationships or what exactly are you looking to do?

Rather than better, I think it’s really just in many ways different, and there’s just different trade-offs that are created in turn.