OCM Quality Measures
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 the National Quality Strategy Domains, including:
- Communication and Care Coordination
- Person and Caregiver-Centered Experience and Outcomes
- Clinical Quality of Care
- Patient Safety
Download the fact sheet on Care Guidance for cancer patients to learn more.
OCM Quality Measures and Performance-Based Payments
12 of the OCM quality measures selected from the above domains are used in the calculation of participants’ performance-based payments. These measures include:
|Measure Name||OCM Measure Number||Measure Source|
|Communication and Care Coordination|
|Risk-adjusted proportion of patients with all-cause hospital admissions within the 6-month episode||OCM-1||Claims|
|Risk-adjusted proportion of patients with all-cause emergency department visits or observation stays that did not result in a hospital admission within the 6-month episode||OCM-2||Claims|
|Proportion of patients who died who were admitted to hospice for 3 days or more||OCM-3||Claims|
|Person- and Caregiver-Centered Experience and Outcomes|
|Pain Assessment and Management Composite1||OCM-4||Registry (practice-reported)|
|Preventive Care and Screening: Screening for Depression and Follow-Up Plan (CMS 2v6.3, NQF 0418)||OCM-5||Registry (practice-reported)|
|Patient-Reported Experience of Care||OCM-6||Survey|
|Clinical Quality of Care|
|Prostate Cancer: Adjuvant Hormonal Therapy for High or Very High-Risk Prostate Cancer (PQRS 104, NQF 0390)2||OCM-7||Registry (practice-reported)|
|Adjuvant chemotherapy is recommended or administered within 4 months (120 days) of diagnosis to patients under the age of 80 with AJCC III (lymph node positive) colon cancer (NQF 0223)3||OCM-8||Registry (practice-reported)|
|Combination chemotherapy is recommended or administered within 4 months (120 days) of diagnosis for women under 70 with AJCC T1cN0M0, or Stage IB – III hormone receptor negative breast cancer (NQF 0559)3||OCM-9||Registry (practice-reported)|
|Trastuzumab administered to patients with AJCC stage I (T1c) – III and human epidermal growth factor receptor 2 (HER2) positive breast cancer who receive adjuvant chemotherapy (NQF 1858)3||OCM-10||Registry (practice-reported)|
|Breast Cancer: Hormonal Therapy for Stage I (T1b)-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer (CMS 140v5.0, NQF 0387)3||OCM-11||Registry (practice-reported)|
|Documentation of Current Medications in the Medical Record (CMS 68v6.1, NQF 0419)||OCM-12||Registry (practice-reported)|
1The composite measure, OCM-4, is comprised of two measures: OCM-4a, Oncology: Medical and Radiation – Pain Intensity Quantified (PQRS 143, NQF 0384), and OCM-4b, Oncology: Medical and Radiation – Plan of Care for Pain (PQRS 144, NQF 0383).
2OCM-7 was retired effective with the March 2018 reporting period.
3OCM-8 – OCM-11 were retired effective with the March 2019 reporting period.
More OCM Resources: