Tennessee Oncology Achieves High Quality Score and Save Millions During the Final Year of Medicare’s OCM

Partners | <b>One Oncology</b>

The community oncology organization, Tennessee Oncology, reportedly saved Medicare $5 million between 2019 and 2020.

Despite 3-year results showing that Medicare did not generate healthcare savings through the Oncology Care Model (OCM), a community oncology organization, Tennessee Oncology, saved Medicare $5 million, according to a press release issued by OneOncology.1

The OCM is an effort of the Centers for Medicare and Medicaid (CMS) Innovation. The program involves new payment and delivery models designed to help improve the way specialty care organizations run. This includes more effectiveness and efficiency, according to CMS. To execute CMS, 5 major insurance companies have been involved and new stipulations were implemented to electronic health records and evaluations in practices.2

“Tennessee Oncology is committed to providing the highest quality care possible to our patients throughout and surrounding Tennessee, while also reducing the financial burden of cancer care. Our OCM data is proof that we are on the right track,” said Stephen Schleicher, MD, medical director of Value-Based Care at Tennessee Oncology, in a press release.

“To accomplish these results, we invested heavily in data analytics, created care navigation touchpoints, and incorporated electronic patient-reported outcome monitoring to improve patient care. It is exciting to see these efforts working to improve quality and reduce cost for our patients,” Leah Owens, executive director of Care Transformation at Tennessee Oncology said in the press release.1

The final year of data from OCM covers the second half of 2019 through quarters 1 and 2 of 2020. While the initial savings were $5 million, Tennessee Oncology also removed care management payments, bringing the total to $10 million in savings.

As part of the OCM, data reporting and quality measurements were also required as a way to understand the effectiveness of the program. The quality score achieved by Tennessee Oncology was 100%. The organization cites the implementation of pain and depression assessment and management for patients as well as patient experience, reducing emergency department visits, and offering patient-centered hospice care. Most notably. Emergency department visits at Tennessee Oncology decreased by 34% and their hospitalization rate was reduced by 29%.

The organization also credits its partnership with Sara Cannon Research Institute to actively enroll patients with no FDA-approved treatment options into clinical trials.

“Transforming to value-based care is not easy and takes time. With over 170 oncology providers serving patients in over 30 clinics across the state, implementing change is hard. The recent OCM report suggests the model did not succeed; however, our experience shows that for practices that commit to high-value care, change takes time and 3 years of data may not be enough to draw a conclusion. For Tennessee Oncology, we are finally here and excited to be on the cutting edge of care delivery innovation to improve patient care, said Natalie Dickson, MD, president, and chief medical officer of Tennessee Oncology, in the press release.

“This doesn’t stop with our Medicare population,” Dickson added “We have now expanded these innovation efforts with the creation of one of the largest commercial insurance oncology medical home models in the country through Ascension and Blue Cross Blue Shield. Putting patients front and center, we are excited for what the future holds.”

References:

1. Tennessee Oncology receives perfect quality score while saving Medicare $5 million during last year of Oncology Care Model. News release. Tennessee Oncology. November 20, 2021. Accessed November 23, 2021. https://bit.ly/3l5pxrX

2. Oncology Care Model. CMS.gov. Accessed November 23, 2021. https://innovation.cms.gov/innovation-models/oncology-care