Has the Oncology Care Model improved quality of oncology care?

Abstract

2 Background: The Oncology Care Model (OCM) was a voluntary episode-based alternative payment model designed to improve the value of care for fee-for-service Medicare beneficiaries receiving systemic therapy for cancer. Participating practices received monthly payments to support care transformation and could earn performance-based payments (or be responsible for recoupments) dependent on meeting quality and spending goals during 6-month episodes. We examined OCM impacts on quality, including measures on which performance-based payments were based and other measures of timely and effective care. Methods: We evaluated OCM impacts on care quality during 6-month episodes before (July 2014-January 2016) and after (July 2016-June 2021) OCM began using a difference-in-differences design. Patient episodes were attributed to OCM-participating practices (n=202) or propensity score-matched comparison practices (n=534). We examined 3 of the 5 quality measures used to determine OCM performance-based payments in OCM - measures that we could assess for both OCM and comparison episodes - and nine additional measures of oncology care quality endorsed by the Centers for Medicare & Medicaid Services, the National Quality Forum, the American Society of Clinical Oncology, or national guidelines. Statistical significance was defined as p<0.10 to avoid missing program impacts. Results: We studied 1,502,665 OCM and 1,662,859 comparison episodes. There was no impact of OCM on quality measures for determining performance-based payments (Table). There was no or modest impact on other measures of oncology care quality (Table). Conclusions: Both OCM and comparison groups showed improvements across quality measures, but OCM practices did not improve significantly more than the comparison practices. [Table: see text]