CMS Announces the Enhancing Oncology Model – Focusing on Value-Based, Patient-Centered Cancer Care
By ION
The Centers for Medicare and Medicaid (CMS) have created a new reimbursement model – the Enhancing Oncology Model (EOM) which is a 5-year voluntary model beginning July 1, 2023. Under EOM, participating oncology practices will take on financial and performance accountability for episodes of care surrounding systemic chemotherapy administration to patients with common cancer types. This new model aims to improve quality and reduce costs through payment incentives and required participant redesign activities.1
The Centers for Medicare and Medicaid (CMS) have created a new reimbursement model – the Enhancing Oncology Model (EOM) which is a 5-year voluntary model beginning July 1, 2023. Under EOM, participating oncology practices will take on financial and performance accountability for episodes of care surrounding systemic chemotherapy administration to patients with common cancer types. This new model aims to improve quality and reduce costs through payment incentives and required participant redesign activities.1
In a high-level comparison of the EOM to the OCM (Oncology Care Model, which has an end date of June 30, 2023), the EOM will focus on health equity. CMS is looking “how to improve health care providers’ ability to deliver care centered around patients, consider patients’ unique needs, and deliver cancer care in a way that will generate the best possible patient outcomes.”
Participants in the EOM will be incentivized to “consider the whole patient and engage with them proactively, during and between appointments”. Some of the main differences, in addition to the focus on health equity, are:
- Requirement for gradual implementation of electronic patient-reported outcomes (ePROs)
- Lower per-beneficiary per-month Monthly Enhanced Oncology Services (MEOS) payment - $70.00 per beneficiary/month - additional $30.00 for Dual eligible beneficiary
- Cancer-type specific approach to calculating benchmarks
- Immediate required downside risk
- Limit model to beneficiaries receiving systemic chemotherapy (not beneficiaries receiving hormonal therapy only) for seven cancer types
The Enhancing Oncology Model (EOM)Request for Applications (RAF) included a comparison of the OCM to the EOM which can be found at: https://innovation.cms.gov/media/document/eom-rfa
The application submission period for the EOM is slated to end on September 30, 2022 at 11:59 pm ET. To apply to participate in EOM, applicants must submit their applications at https://app.innovation.cms.gov/EOM
1. https://innovation.cms.gov/innovation-models/enhancing-oncology-model
