Enhancing Oncology Model Opportunities

CMS, through CMMI, has introduced another new payment model demonstration project that has great partnering potential for palliative care providers. On July 1, 2023, the Enhancing Oncology Model (EOM) went live. The EOM is the evolution of the Oncology Care Model (OCM) which ended in June of 2022. Providers in the EOM receive a monthly payment and a performance-based payment with the expectation that they will improve the quality and reduce the cost of care for their cancer patients. 

While partnerships with palliative care providers are not specifically called for in the EOM – as it was in the OCM – there are aspects of the EOM that make such collaborations advantageous. Patients aligned with EOM providers are to receive 24/7 access to clinicians, patient navigation, goals of care conversations, discussions of treatment and prognosis, symptom management, and screening for social determinants of health. These are the components built into many community-based palliative care programs. For oncologists already dealing with many demands through their practices, partnering with community-based providers who are experts in these specific skill sets to take on these tasks can be a great benefit to them. For the palliative care provider, this can serve as a revenue stream for their PC program as well as generating patient familiarity with their organization. The PC provider can also take on some risk through the performance-based incentives built into the EOM, which can be a financial boon for both the EOM practice and the PC provider. EOM is limited to seven cancer types: breast cancer, chronic leukemia, small intestine/colorectal cancer, lung cancer, lymphoma, multiple myeloma, and prostate cancer. EOM is also not yet nationwide. Specific providers can be found at https://innovation.cms.gov/innovation-models/enhancing-oncology-model. If an EOM participant practice is in your market, this is definitely a partnership opportunity for you to investigate, especially before another post-acute care provider in your market does. Acclivity can help you understand more about the program, assist you in developing your PC program to meet the needs of EOM providers, and help explore interconnectivity with the practice.

Source Material:

“How Palliative Care Fits in to CMMI’s Enhancing Oncology Model” by Jim Parker posted on July 5, 2023, by Palliative Care News and accessible at https://hospicenews.com/2023/07/05/how-palliative-care-fits-in-to-cmmis-enhancing-oncology-model