Oncology Practices Re-evaluate Value-Based Care Amidst EOM Challenges
WASHINGTON, D.C. – Oncology practices participating in the Enhancing Oncology Model (EOM) are reassessing their involvement as delayed data,fluctuating drug costs,and increasing administrative burdens threaten the program’s viability,according to a panel of experts discussing the evolving landscape of value-based care. The discussion, highlighting frustrations mirroring those experienced during the Oncology Care Model (OCM), comes as practices face a November 30th deadline to decide whether to continue with EOM.
the shift follows recent clinical advancements, such as the FDA approval in July 2024 of a 4-drug regimen for newly diagnosed multiple myeloma – a decision informed by the PERSEUS trial presented at the American Society of Hematology in December 2023 – which are impacting treatment costs and possibly, EOM performance metrics.
Panelists detailed how the original OCM saw cost savings through biosimilar utilization, a benefit now eroded by “more expensive biosimilars and the rise of 505(b)(2) drugs,” explained one expert. This has created “a very unstable” market, according to Blau.
A core concern centers on the notable lag time between patient care and the availability of performance data. “How can practices learn if 2 more performance periods elapse before they get data?” a panelist questioned, highlighting the difficulty of reacting to trends in real-time.As Indurial put it,the EOM is “a nicely designed map without a compass,” leaving oncologists without immediate insight into national drug pricing trends and their impact on trend factor calculations. Treatment decisions, they emphasized, are still driven by patient needs, payer coverage, and drug availability.
The administrative burden associated with EOM is also growing as opportunities for performance-based payments diminish. Indurial noted the proliferation of varied programs from commercial payers and Medicare Advantage plans, requiring practices to “navigate each one of them individually.” Despite automation efforts, Ingram stressed, “You can’t understate the manual nature” of data extraction.
Efforts to streamline reporting by aligning EOM with the Merit-based Incentive Payment System (MIPS) have faced challenges, with some self-selection measures proving incompatible with broader reporting requirements, according to Baker.
Participation numbers also reveal a shrinking program. While OCM launched with over 200 practices and concluded with 122 in June 2022, EOM began with 44 and currently lists 38 on its website. several panelists indicated uncertainty about their future participation. While Ingram stated his practice would remain in the program for now, Indurial’s team will “undertake a deeper look at whether participation makes sense on an ongoing basis,” emphasizing the need to maintain financial stability to ensure continued patient access to care. “Because at the end of the day, we have to keep the doors open. Or else, patients don’t get care,” he concluded.