Did the Oncology Care Model produce cost savings? – Healthcare Economist


The answer is ‘yes’, but the magnitude of these savings are relatively small and more than offset by additional OCM program costs. Keating et al. (2021) writes:

In this exploratory difference-in-differences study of Medicare fee-for-service beneficiaries with cancer undergoing chemotherapy (483 310 beneficiaries with 987 332 episodes treated at 201 OCM participating practices and 557 354 beneficiaries with 1 122 597 episodes treated at 534 comparison practices), OCM was associated with a statistically significant relative decrease in total episode payments of $297 that was not sufficient to cover the costs of care coordination or performance-based payments. There were no statistically significant differences in most measures of utilization, quality, or patient experiences.

On average, the cost of an OCM episode was about $30,000. Thus, implementation of OCM resulted in a 1% cost savings. However, these savings in Medicare claim cost payments were offset by additional Monthly Enhanced Oncology Services payments of ($704). In short, implementing OCM cost Medicare about $400 per patient, or a little over a 1% increase in episode cost.


Source link