Bundled Payments

When it comes to oncology, how you handle payments can make all the difference. Not only does it allow your healthcare organization to maintain better revenue forecasts — but it also empowers patients to receive quality care while meeting their other financial obligations. In this blog post, let’s cover bundled payments for care improvement. That […]

The Centers for Medicare and Medicaid Services created the Bundled Payments for Care Improvement Advanced (BPCI Advanced) model to improve the quality of care and reduce costs. In this model, providers receive a set payment to cover all services associated with a particular episode of care. Read more: What is BPCI (Bundled Payments for Care […]

BPCI-A, the latest iteration of the Bundled Payments for Care Improvement initiative from the Centers for Medicare and Medicaid Services (CMS), is now open for applications. If you’re unfamiliar with BPCI or its predecessors, it’s worth looking at this new program. CMS has identified an increased focus on episode payment models as a critical area […]

The Bundled Payments for Care Improvement (BPCI) Advanced model is a new initiative from the Centers for Medicare and Medicaid Services (CMS). This program builds on the success of the original BPCI program and aims to improve quality and lower patient costs. Read more: What is BPCI (Bundled Payments for Care Improvement)? We will discuss […]

The Centers for Medicare & Medicaid Services plans to roll out the Radiation Oncology Model (ROM) in January 2022, which will cover radiotherapy episodes of care. Participation is mandatory in select zip codes—you can access the current list here—and will cover physician group practices, hospital outpatient departments, and freestanding radiation therapy centers. To help providers […]

CMS recently announced the Radiation Oncology Model (RO Model or RO-APM), a mandatory, episode-based payment model for radiotherapy (RT) services. CMS states that the goals of the model are to “improve the quality of care for cancer patients receiving radiotherapy…and move toward a simplified and predictable payment system.” The new radiation oncology alternative payment model […]

Bundled Payments for Care Improvement (BPCI) was an initiative created by the Center for Medicare and Medicaid Innovation (CMMI) to test the efficacy of several different episode-based payment models in producing higher quality, more coordinated health care at a lower cost to Medicare. BPCI was launched in 2013 concluded in 2018. The BPCI Advanced Model […]

OCM 2.0 is a proposed alternative to the current Oncology Care Model (OCM) program, and was created by the Community Oncology Alliance (COA) in June 2019. COA submitted OCM 2.0 to the Physician-Focused Payment Model Technical Advisory Committee (PTAC), an advisory committee that evaluates physician-focused payment models for the Secretary of Health and Human Services […]

The Oncology Care Model (OCM) is an episode-based payment model designed to provide high quality, highly coordinated oncology care at low cost. In order to assess and verify clinical outcomes, patient outcomes, and coordination of care, as well as ensure continued quality of care, CMS measures OCM participants’ performance using quality measures from four of […]

A Monthly Enhanced Oncology Services (MEOS) payment is part of the two-part payment system specific to the Oncology Care Model (OCM). Under OCM, participating Medicare-enrolled physician groups continue to receive regular fee-for-service (FFS) Medicare payments, but also receive a MEOS payment of $160 per-beneficiary for delivery of “enhanced services,” as well as a retrospective performance-based […]

The Oncology Care Model (OCM) is an episode-based payment model developed by the Centers for Medicare & Medicaid Services Innovation Center (CMMI) in order to improve the quality of care cancer patients receive at the same or lower cost. According to the National Cancer Institute, “In 2018, an estimated 1,735,350 new cases of cancer [were] […]

In remarks to the Patient-Centered Primary Care Collaborative, HHS Secretary Alex Azar confirmed that new mandatory bundled payment models are coming. During his tenure as Secretary of HHS, Azar has consistently signaled that new, required episode-based payment models are coming, and elaborated on those plans in yesterday’s remarks, saying, “We need results, American patients need change, and […]