Kashyap Patel, MD, CEO of Carolina Blood and Cancer Care, explains how previous experience with alternative payment models helped a smooth transition into the Oncology Care Model (OCM).
Kashyap Patel, MD, CEO of Carolina Blood and Cancer Care, explains how previous experience with alternative payment models helped a smooth transition into the Oncology Care Model (OCM).
Transcript
Has your practice been involved in alternative payment model partnerships and did it help prepare for implementing the Oncology Care Model?
We had almost a dry run of the OCM. Before the OCM started we had partnered with Blue Cross Blue Shield of South Carolina on a care quality model. It was somewhat similar to OCM where we had to report some of the quality measures. It was confined to 3 different tumor types, which was breast cancer, colon cancer, and lung cancer, at the time. And so we had a monthly per member payment experience and how to incorporate that into the delivery of seamless care, which included same-day appointments, reporting quality measures. So we had a dry run with Blue Cross Blue Shield, which allowed us an easy segue to the OCM.
Blue Cross Blue Shield agreed to allow us to be eligible for added payment per month per beneficiary. In return, we had to meet certain standards. We had to follow national guidelines for treatment, we had to report the quality measures. We had to go for a shared decision making process, which included discussing the prognosis, included discussing stage. So we went a step further in getting true patient-centered experience in return for monthly payment of $350 per patient per month that we were being given for 8 months and then with the OCM we shifted into the Blue Cross Blue Shield OCM, which was somewhat different than what we had before.
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