Key CMMI updates to the EOM  The Center for Medicare and Medicaid Innovation (CMMI) released exciting updates to the Enhancing Oncology Model (EOM) along with a new opportunity for a second cohort of participants.   The EOM aims to enhance the quality of care for cancer patients while reducing costs under the Medicare fee-for-service program. The updates come on the heels of lower-than-expected model participation .   This blog will discuss key EOM updates, application details, eligibility requirements and important deadlines.  New cohort opportunity  Request for applications: CMS issued an RFA to recruit a second cohort of participants and payers for the EOM.  Timeline:  Second cohort start date: July 1, 2025  Second cohort end date: June 30, 2030  Initial performance period start date: July 1, 2023  Model test end date for all participants: June 30, 2030 (extended from June 30, 2028)  Notable changes to the EOM model...

Six years after its launch, CMS’ Oncology Care Model ended on June 30, 2022. Oncology practices that participated and stayed through the entirety of the program had clinical buy-in for the delivery of value-based care for cancer patients. However, despite CMS’ desire for a replacement model to continue OCM’s practice transformation, its Enhancing Oncology Model didn’t attract critical mass. At this point, you may be asking yourself, “What happened to all the practices that participated in OCM? Why didn’t they choose to continue?” In this blog, DataGen will answer those questions with three observations about EOM. Observation #1: Failure to meaningfully incorporate clinical adjustments CMS failed to incorporate clinical adjustments into EOM’s target price methodology in a meaningful way, beyond what was demonstrated in the final performance periods of OCM . Instead of factoring clinical data elements into the underlying cancer-specific regression models, EOM continues to incorporate a ...

Many CMS value-based care models seek to improve care coordination and reduce Medicare fee-for-service spending through episode-based payment and practice transformation. The agency’s new Enhancing Oncology Model applies these objectives to cancer care. There are many good reasons for any oncology practice to join EOM and improve the delivery of cancer care to its patients. But value-based care also raises the stakes. Participation alone doesn't guarantee success. Using analytics helps providers “trust but verify” ─ to not simply believe they are improving care quality and reducing costs, but know where they stand through tangible metrics. This blog post explores three best practices that help ingrain analytics in EOM practice, redesign and performance. How to anchor analytics for EOM performance 1. Estimate episode target prices for financial analyses Financial realities dictate whether practices join EOM, under what risk arrangement and if it's for the long term. Participati...

CMS’ new Enhancing Oncology Model seeks to improve cancer care coordination, drive practice transformation and reduce Medicare fee-for-service spending through episode-based payment. Launched July 1, EOM replaces the Oncology Care Model as CMS seeks to build on lessons learned and challenges of cancer care cost management. In this blog, we explore five best practices your oncology practice can use to kick-start EOM. How to operationalize your Enhancing Oncology Model 1. Lay the foundation with core value-based care principles While CMS models change, many value-based care elements are evergreen and can benefit from practices that: identify physician champions; inform and align practice leadership; define success markers to track progress; identify core team member roles and goals; and establish quality measure reporting. The latter may require EOM practices to add metrics to their electronic health records, such as depression screening and pain management. While this example is model-...

The Centers for Medicare and Medicaid Services Innovation Center recently announced approved applicants for the new Enhancing Oncology Model. If your facility has been selected by CMS, are you still weighing your options during the current baseline evaluation period?  Two deciding factors may include the program data that CMS provides and whether EOM is enough of an improvement over the prior Oncology Care Model to make your investment worthwhile. Another factor to consider: Will you have the resources in place to conduct a baseline evaluation before EOM’s program start on July 1, 2023? How EOM differs from OCM EOM aims to improve the coordination of oncology care, drive practice transformation and reduce Medicare fee-for-service spending through episode-based payment. It includes three major updates: Fewer cancer types. Compared with OCM’s 21, EOM will be limited to seven common cancer types: breast, prostate, lung, small intestine/colorectal, multiple myeloma, lymphoma and chroni...

As the final at-risk period for the Oncology Care Model was closing at the end of June, the Center for Medicare and Medicaid Innovation announced its new Enhancing Oncology Model (EOM). EOM aims to improve the coordination of oncology care, drive practice transformation and reduce Medicare fee-for-service spending through episode-based payment.  What is EOM? EOM is a voluntary, five-year model set to begin July 1, 2023. Patients undergoing chemotherapy for the treatment of cancer will trigger six-month episodes of care.  Eligible EOM participants include physician group practices with at least one Medicare-enrolled physician or a non-physician practitioner who furnishes evaluation and management services to Medicare beneficiaries receiving chemotherapy for cancer treatment.  EOM participants are required to implement eight participant redesign activities to drive care transformation in their practice. Examples include the provision of patient navigation, 24/7 access ...