Tag: APMs

OCM 2.0 OCM 2.0

What is OCM 2.0?

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 (HHS).

Challenges of the Original OCM Program

The proposal is based on feedback from current OCM participants and “lessons learned from other alternative payment models (APMs).” (AJMC, 2019). The proposal points to several challenging areas faced by participants in the existing model as the impetus for the proposal, including:

  • Data and reporting requirements
  • The need for more practice input and guidance
  • Questions about whether the current model utilizes the right quality measures
  • The need for more timely and meaningful feedback

Care Guidance for Cancer Patients Fact Sheet

Guideway’s Care Guidance services support quality care while driving down costs. After continuing Care Guidance services, a large academic medical center captured more than $2M in shared savings under OCM.

Download the fact sheet on Care Guidance for cancer patients to learn more.

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Proposed Improvements in OCM 2.0

OCM 2.0 seeks to address these shortcomings and improve upon the existing model, and outlines several major components:

  • A care coordination fee that continues to support participants’ role as a medical home for patients
  • Quality measures that are relevant, meaningful and practical, and that can be collected electronically
  • An expansion of risk adjustment to better account for the variations in cancer type, comorbidities, complications, etc.
  • Shared savings that would allow transparency and performance competition among model participants

COA underscored that 2.0 is not meant to be a final version of OCM, but rather a step in an iterative process aimed at providing higher quality care, with a better patient experience, at lower cost.

More Resources for the Oncology Care Model:

Guideway Care reduces unnecessary utilization/cost of care and improves patient compliance and satisfaction. Request more information about how Guideway can help you succeed under OCM today.

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What is a MEOS Payment? | What is a Monthly Enhanced Oncology Services Payment? What is a MEOS Payment? | What is a Monthly Enhanced Oncology Services Payment?

What is a MEOS Payment?

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 payment for the OCM episode, which lasts six months from the start of chemotherapy. MEOS payments could be substantial for many OCM participants, with $160 per month over a six-month episode totaling $960 per episode. Practices with 1,000 episodes would receive close to $1 million in MEOS payments.

Enhanced Services

CMS defines the “enhanced services” required in order to receive a MEOS payment as:

  • The core functions of patient navigation;
  • A care plan that contains the 13 components in the care management plan outlined in the Institute of Medicine report, “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis”;
  • Patient access 24 hours a day, 7 days a week to an appropriate clinician who has real-time access to practice’s medical records; and
  • Treatment with therapies consistent with nationally recognized clinical guidelines.

Care Guidance for Cancer Patients Fact Sheet

Guideway’s Care Guidance services support quality care while driving down costs. After continuing Care Guidance services, a large academic medical center captured more than $2M in shared savings under OCM.

Download the fact sheet on Care Guidance for cancer patients to learn more.

[pardot-form height=”170″ id=”20312″ title=”Guideway Care Cancer Fact Sheet Download”]


The MEOS Payment and Care Coordination

The OCM was launched by CMMI in order to improve the quality of care cancer patients receive at the same or lower cost. OCM was introduced as a five-year model as a five-year model (2016-2021) in order to test payment strategies designed to produce higher quality care, lower costs, and better outcomes.

The “enhanced services” that must be delivered in order to receive a MEOS payment are essential to achieving the goals of OCM, but many participating practices did not initially have the infrastructure/resources in place to provide these services. The Monthly Enhanced Oncology Services payment is intended to assist participating practices by providing the financial resources to support their capabilities in care management and coordination.

MEOS and OCM 2.0

With the initial term of OCM drawing to a close in 2021, those with an interest in the model are looking to the future. The Community Oncology Alliance (COA) recently proposed an alternative to OCM in June 2019, known as OCM 2.0. 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 (HHS).

OCM 2.0 seeks to address the challenges participants face in the current iteration of OCM and improve upon the existing model. One of the key components discussed by COA in its 2.0 proposal is the need for participants to continue to receive some sort of care coordination fee in support of care management and coordination services which it deems “essential if oncology practices are to be a true medical home for patients with cancer.”

With the overwhelming burden of cancer on the U.S. healthcare system and the continued focus on value-based payment models, the Oncology Care Model will help shape the future of cancer care. Care coordination, and by extension, some form of the MEOS payment, will also likely have a role to play in future iterations of OCM.

More OCM Resources:

Guideway Care reduces unnecessary utilization/cost of care and improves patient compliance and satisfaction. Request more information about how Guideway can help you succeed under OCM today.

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The Oncology Care Model: An Overview The Oncology Care Model: An Overview

The Oncology Care Model: An Overview

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] diagnosed in the United States and 609,640 people will die from the disease.” In addition, many of those diagnosed are over 65 years old and Medicare beneficiaries, making cancer an even more substantial concern for the federal government. In order to address the individual and societal burdens of cancer in the U.S., the OCM was introduced as a five-year model (2016-2021) in order to test payment strategies designed to produce higher quality care, lower costs, and better outcomes.


Care Guidance for Cancer Patients Fact Sheet

Guideway’s Care Guidance services support quality care while driving down costs. After continuing Care Guidance services, a large academic medical center captured more than $2M in shared savings under OCM.

Download the fact sheet on Care Guidance for cancer patients to learn more.

[pardot-form height=”170″ id=”20312″ title=”Guideway Care Cancer Fact Sheet Download”]


OCM participants consist of Medicare-enrolled physician groups, including hospital-based practices. There are currently 175 practices across the U.S. participating in OCM, covering more than 150,000 Medicare beneficiaries. Participants are required to implement “practice redesign activities,” and are incentivized to provide comprehensive, high-quality care that focuses particularly on improving patient experience and outcomes. The Oncology Care Model targets a 6-month window of treatment for cancer patients begins with chemotherapy. Participants must provide “enhanced services,” use data to drive quality improvement, and use certified electronic health record technology (CEHRT). Participants’ performance is assessed using a set of quality measures, including 12 measures which are used to calculate performance-based payments.

The Oncology Care Model is a multi-payer model that includes Medicare fee-for-service (OCM-FFS) as well as Medicare-aligned commercial payers. OCM participants continue to receive regular fee-for-service (FFS) payments during the model, but also uses a two-part payment for participants designed to drive quality improvements and enhanced services including a Monthly Enhanced Oncology Services (MEOS) payment of $160 per-beneficiary for delivery of enhanced services, as well as a performance-based payment for the OCM episode.

More OCM Resources: