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CMS’ oncology various fee mannequin diminished utilization of imaging providers in Medicare

Share this…FacebookPinterestTwitterLinkedin The Facilities for Medicare & Medicaid Providers’ oncology various fee mannequin produced decrease utilization of imaging providers, in…

By Staff , in Medicare , at November 10, 2021



The Facilities for Medicare & Medicaid Providers’ oncology various fee mannequin produced decrease utilization of imaging providers, in accordance with new analysis printed Tuesday in JAMA.

CMS launched the five-year, value-based care effort in 2016 aiming to manage most cancers therapy prices, which reached $200 billion final yr. Beneath the Oncology Care Mannequin, about 200 doctor practices inked agreements to bolster coordination and cut back unplanned take care of sufferers receiving chemotherapy.

Researchers sought to research the mannequin’s influence on healthcare spending, utilization and high quality in the course of the first three years. They discovered the mannequin was considerably related to modest decreases, together with about 46 fewer imaging providers used per 1,000 care episodes.

All informed, the Oncology Care Mannequin produced a $297 per-episode lower in Medicare episode funds (about $18 fewer on imaging), which was inadequate to offset CMS’ funding within the effort.

“The OCM was not related to a decline in any crucial high quality measures, and this unfavorable result’s noteworthy,” Raymond Osarogiagbon, MBBS, with Baptist Memorial Well being Care Corp. in Memphis, Tennessee, and colleagues wrote in a corresponding editorial. “One of many chief considerations of value-based fee fashions is the theoretical threat that monetary incentives will induce restrictions in important care. The OCM had no demonstrable opposed results on care high quality and in that essential respect represents a optimistic end result.”



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