Value-Based Reimbursement

Alternative Payment Models

Community-based cancer care is the most cost-effective setting for Medicare and its beneficiaries and The US Oncology Network continues to engage with the Centers for Medicare & Medicaid Services (CMS) in developing new value-based payment methods for cancer care.

Oncology Care Model/Oncology Care First Model

The US Oncology Network is committed to working with CMS to enhance the delivery of cancer care and protect patient access to high‐quality care in the most efficient manner. This dedication is demonstrated by the 15 oncology practices within The Network, encompassing more than 900 providers, that are participating in CMS’s Oncology Care Model. These practices have accepted the challenge of participating in the pilot with the shared goal of improved patient outcomes and cost savings for the Medicare program. Network practices have embraced innovation in both treatment options and care delivery, and are actively working to transition to value based care. In November 2020, The Network enrolled its 100,000th patient in OCM. In realizing this goal, the participating Network practices delivered $148 million in cumulative savings to Medicare over the program’s first seven performance periods.

The US Oncology Network submitted comments to the Center for Medicare and Medicaid Innovation (CMMI) in response to its Request for Information (RFI) on the Oncology Care First (OCF) model. The OCF model would be a voluntary, five-year, total cost of care model intended as the successor to the OCM. The OCF model was originally slated to begin in January 2021, when there are no new episodes initiating in the OCM. However, due to COVID-19, CMMI extended the OCM for an additional year, delaying implementation of the OCF model.

Additional Resources