Oncology Care Model lines up more than 400 practices for value-based payment test (list)

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More than 400 oncology practices across the United States have signed up to participate in a new federal payment model that moves traditional cancer treatments away from a fee-for-service model to value-based payment.

The program is one of the Centers for Medicare and Medicaid Services "innovation models," among a host of programs including accountable care and bundled payment models that mostly seek a similar end: to convert how healthcare providers are paid for services by emphasizing the quality of care over quantity.

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With the Oncology Care Model, participating practices will have their chemotherapy treatments tracked and measured for the necessity and outcome of the treatment, as well as the coordination of care that leads up to the cancer treatment. Like all value-based programs, the aim isn't necessarily to reduce the number of treatments, but to ensure that patients are screened ahead of treatment and that their health at the end of treatment is a factor in how much the provider is paid. It also includes the monitoring of side effects to keep patients from ending up in the hospital with complications, which can add to the cost of care.

Providers will receive incentives based on patient experience, payer negotiations and the overall health outcomes for patients.

The program, however, carries political risk, according to a recent piece in the National Journal. While health care reforms are starting to become embedded in the U.S. system, the risk is that there will be opposition to this program. The concern is that doctors will be less eager to offer these cancer treatments because of cost concerns.

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But CMS hopes the model will only improve care.

As for payment, participating providers will be paid in two stages. First, practices will receive monthly payments based on the number of beneficiaries they have undergoing an episode of treatment. In that payment, providers will get $160 per beneficiary. Then, providers will get an incentive payment after care is completed that takes into account quality and outcomes.

The 443 providers listed below, which include small practices as well as major health systems, applied before the May 7 cutoff. CMS will narrow down the list and announce the final program participants within 6 months.

Twitter: @HenryPowderly