New Oncology, Primary Care Models Could Offer… Leave a comment

The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) are taking steps to improve oncology care and primary care this week.

While both are not directly related to home-based care, the federal government pushing this should pique providers’ interest. After all, both primary and oncology care have been woven into the home-based care landscape more and more over the last few years.

The Center for Medicare & Medicaid Innovation (CMMI) announced the Enhancing Oncology Model (EOM) Monday, which intends to “transform care for cancer patients, reduce spending and improve quality of care.”

The model’s design, according to CMMI, will test how to best place cancer patients at the center of a care team that provides high-value, equitable and evidence-based care.

It’s a move that was foreshadowed by the former CMS Administrator Seema Verma just last week.

“There’s bigger models on oncology and kidney care that I do see continuing,” she said.

The model is a voluntary one, however. Voluntary models generally create less savings and show less success, for obvious reasons, than mandatory ones do.

The model’s design incorporates lessons that CMS learned from the Oncology Care Model (OCM), which was tested from 2016 until now.

EOM participants will have the chance to take on risk and earn a retrospective performance-based payment, which is based on quality and savings. Participants will be required to take a downside risk at the start of the model.

From a home-based care perspective, the in-home cancer care enabler Reimagine recently raised $25 million in funding. Reimagine has also said repeatedly it plans to work with home-based care providers. Signify Health (NYSE: SGFY) also teamed up with the Children’s Oncology Group last year to provide cancer care in the home.

The EOM could potentially give home-based care providers an alternate route to enter into risk-based care models.

Primary care has been another area to do that in the past. For instance, primary care groups such as Emcara Health have brought on providers to join into risk-based agreements with it.

HHS is currently requesting comments on how primary care can be improved in the U.S. Specifically they’re looking for “successful models or innovations that improve primary health care and help achieve the HHS goal state for primary health care.”

Additionally, they want to recognize the barriers to implementing successful models or innovations, successful strategies to engage communities and proposals for where HHS should take action.

“The goal of the U.S. Department of Health and Human Services Initiative to Strengthen Primary Health Care is to develop a federal foundation for the provision of primary health care for all that supports improved health outcomes and advanced health equity,” a fact sheet read. “The first step is to produce an initial HHS Action Plan in 2022.”

The public comment period will be open until Aug. 1.


Leave a Reply