CMS’s alternative oncology payment model reduced use of imaging services in Medicare

The Centers for Medicare & Medicaid Services’ alternative oncology payment model has produced lower use of imaging services, according to a new study published Tuesday in JAMA.

CMS introduced the five-year value-based care effort in 2016 to control cancer treatment costs, which reached $ 200 billion last year. As part of the oncology care model, approximately 200 physician offices have signed agreements to strengthen coordination and reduce unplanned care for patients receiving chemotherapy.

The researchers sought to analyze the impact of the model on spending, use and quality of health care in the first three years. They found that the pattern was significantly associated with modest decreases, including about 46 fewer imaging departments used per 1,000 episodes of care.

In total, the oncology model of care produced a decrease of $ 297 per episode in Medicare episode payments (about $ 18 less on imaging), which was insufficient to offset CMS’s investment in it. effort.

“CMO has not been associated with a decline in critical quality measurements, and this negative result is remarkable,” wrote Raymond Osarogiagbon, MBBS, with Baptist Memorial Health Care Corp. in Memphis, Tennessee, and colleagues in a corresponding editorial. “One of the main concerns of value-based payment models is the theoretical risk that financial incentives lead to restrictions in essential care. CMO had no demonstrable adverse effects on the quality of care and, in this important respect, represents a positive result.

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