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Evaluation of the Oncology Care Model: Performance Periods 1-9

Abt Global in partnership with The Lewin Group, Harvard Medical School, Geisel School of Medicine at Dartmouth, General Dynamics Information Technology


May 31, 2023

This interim report covers the first nine out of 11 total performance periods of the Centers for Medicare & Medicaid Services’ Oncology Care Model (OCM). Started in 2016, OCM tested whether financial incentives can improve quality and reduce Medicare spending for Medicare fee-for-service beneficiaries with cancer who are undergoing chemotherapy treatment. OCM paired attributes of medical homes (patient-centeredness, care coordination, accessibility, evidence-based guidelines, and continuous quality improvement) with financial incentives for providing services efficiently and with high quality. Under the model, practices could bill Medicare for additional money on a monthly basis to support care improvements. Practices also could earn money in the form of performance-based payments (PBPs) if they met OCM cost and quality goals.

Findings from this report include:

  • OCM was active in 202 practices across 33 states, covering roughly 1 in 4 Medicare patients receiving chemotherapy.
  • OCM reduced Medicare payments made for patients undergoing chemotherapy by roughly 1.7 percent relative to a comparison group, driven by payment reductions among several higher-risk cancer types.
  • OCM increased use of higher-value (more cost-conscious) supportive care drugs that treat chemotherapy side effects, which generated nearly half of all spending reductions.
  • Despite gross reductions in Medicare payments, PBPs and monthly payments to participants exceeded those reductions, resulting in a net loss to Medicare after accounting for incentive payments made to participating oncology practices.
  • CMS' new Enhancing Oncology Model focuses on higher-risk cancer types and embeds equity into model design, offering the promise of increased quality and net Medicare savings.