How can we drive transformation in oncology care?

Challenge

The CMS Innovation Center’s voluntary Enhancing Oncology Model (EOM) aims to drive transformation and improve care coordination, quality, and health outcomes for patients with cancer while also holding oncology practices accountable for total costs of care to make cancer care more affordable and accessible for beneficiaries and Medicare.

The payment structure used for traditional Medicare fee-for-service (FFS) oncology care can potentially create financial incentives that lead to high cost but low value care and a focus on the disease and not the person, which can lead to fragmented, uncoordinated care.

The model will test how to improve health care providers’ ability to design cancer care centered on patients, consider patients’ unique needs, and deliver cancer care in a way that will generate the best possible patient outcomes.

Solution

Westat supports the Lewin Group in conducting an independent, mixed-methods evaluation of EOM, assessing whether EOM achieves its intended goals of transforming care for cancer patients and practices, reducing Medicare spending, and maintaining or improving quality of care.

Westat will provide oncology care expertise and contribute to key tasks, including:

• Management of a technical expert panel comprising practicing clinicians who specialize in the cancer types included in the Model
• Primary data collection involving surveys of and interviews with Medicare beneficiaries
• Site visits and surveys of oncology practices participating in the Model.

Westat will also support analysis of Medicare claims, SEER-Medicare, and state-level cancer registry data.

Results

EOM’s objective is to improve the experience of people and their families living with and surviving cancer. The model aligns with the Cancer Moonshot pillars and priorities of supporting patients, caregivers, and survivors, learning from all patients, targeting the right treatments for the right patients, and addressing inequities.

EOM aims to enhance the quality of care and coordination for cancer patients while also ensuring that oncology practices remain accountable for the total costs of care. This will make cancer care more affordable and accessible to beneficiaries and Medicare, which are significant priorities for the CMS Innovation Center (CMMI). EOM also includes a focus on improving health equity, another top priority for CMMI. 

Learn more: Enhancing Oncology Model