Overview
The Oncology Care Model (OCM) was a Medicare payment and care-delivery program designed for patients with cancer. Instead of paying only for each individual service, the model added monthly care-management payments to participating oncology practices and tied financial accountability to the total cost and quality of care during a cancer episode. A cancer episode was triggered when a patient began systemic therapy, such as chemotherapy, immunotherapy, targeted therapy, or hormone therapy, for cancer.
A key policy concern about episode-based payment models is whether they may unintentionally encourage more episodes to be started. In oncology, that could mean more patients being placed on systemic therapy, even when the clinical benefit is uncertain. This study examined whether the OCM was associated with an increased likelihood of initiating systemic therapy for cancer.
