CMS Seeks Participants for New Oncology Care Model

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  • February 13, 2015
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The Centers for Medicare & Medicaid Services (CMS) is looking to improve the effectiveness and efficiency of oncology care with a new episode-based payment model called the Oncology Care Model (OCM). CMS is encouraging eligible payers and practices to apply.
The OCM is a five-year model, scheduled to begin next year. Payers and practices interested in participating must send a letter of intent. The deadline for payers to submit a letter of intent is March 19; practices have until April 23. Applications are due by 5 PM (EST) on June 18.
Eligible practices must be able to:

  • Provide core functions of patient navigation;
  • Document a compliant care plan;
  • Provide 24/7 patient access to a clinician who has real-time access to the practice’s medical records;
  • Treat patients with therapies consistent with recognized clinical guidelines;
  • Use data to drive continuous quality improvement; and
  • Use a certified electronic health record and attest to stage 2 of meaningful use by the end of the third model performance year.

The OCM is a multi-payer model that includes Medicare fee-for-service, and will use a two-part payment approach:

  1. A monthly $160 per beneficiary care management payment, and
  2. A performance-based payment, calculated retrospectively following completion of a six-month episode.

Additional information about the OCM, including how to apply, is available on the CMS Innovation website. And CMS is presenting a webinar on the OCM February 19 from 12 PM – 1 PM (EST).

Certified Hematology and Oncology Coder CHONC

Renee Dustman
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Renee Dustman, BS, AAPC MACRA Proficient, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. Renee has more than 20 years experience in print production and content management. Follow her on Twitter @dustman_aapc.

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