Dr Karen van Caulil: End of Oncology Care Model Could Leave Gap in Comprehensive Care

Karen L. van Caulil, PhD, president and CEO of Florida Alliance for Healthcare Value, discusses the potential gap in care that may occur with the end of the Oncology Care Model.

With no oncology model on deck to replace the Oncology Care Model, patients could experience gaps in the comprehensive care they are currently receiving, said Karen L. van Caulil, PhD, president and CEO of Florida Alliance for Healthcare Value.


Are you hearing from providers about the potential gap that is likely to happen in the Oncology Care Model?

Yes, we've heard considerable concern and feedback from oncology providers about the ending of the Oncology Care Model [OCM]—my understanding is that it would end in June 2022, with the wind down starting really soon, January 1, 2022—and the impact it will have on patients and also on providers. It appears that there isn't any oncology model on deck that would replace the Oncology Care Model, so it actually feels more like a void than merely a potential gap in the comprehensive care that a lot of patients are now receiving and benefiting from under this model. I know there's been a lot of studies about the impact, and there are instances where there's improved quality of care [and] better outcomes for patients that results in cost savings for the employers and lower out-of-pocket for patients. If you think about it, the practices have really invested heavily in implementing these services in care management, navigation, financial counseling, data analytics, and some other areas, and it has really supported patients during their cancer patient journey and also in survivorship.

So we’re saying, hey, what happens when the Oncology Care Model ends? Will patients who are now receiving OCM services no longer receive them because practices aren't going to be reimbursed for them and they're unable to continue to provide those services? We definitely support the request that the Community Oncology Alliance has recently made to [the Center for Medicare and Medicaid Innovation]. They have asked them to consider extending that end date to at least the end of December 2022, and to not just toss out the Oncology Care Model, but to look really closely at it and refine it and improve upon it over the next year. We think that's a very reasonable and appropriate request, rather than to just completely stop the program entirely.

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