Oncology Practices Re-evaluate Value-Based Care โAmidstโ EOM Challenges
WASHINGTON,โ D.C. – โขOncology practices participating in the Enhancing โOncologyโ Model โข(EOM) โฃare reassessing โขtheir involvement as delayed โขdata,fluctuating drug costs,and increasing administrative burdensโ threaten the program’s viability,according to a panel of experts discussing the evolving landscape of โขvalue-based care. The discussion, highlighting frustrations mirroring those experiencedโฃ 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 regimenโค for newly diagnosed multiple myeloma – a decision informed by the PERSEUS trial presented atโ the American Society of Hematology in December 2023 – which are impacting treatment costs and possibly, EOM performance โขmetrics.
Panelists detailed how โthe original OCM saw costโ savingsโ through biosimilar utilization, โa benefit now eroded by “more expensive biosimilars andโ the rise of 505(b)(2) drugs,” explained one expert. This has created “a โvery unstable” market, according to Blau.
A core concern centers on the notable lagโฃ time between patientโข care and โthe availability of performance data. “Howโ canโข practices learn if 2 โคmore performance periods elapseโ before they get โขdata?” โฃa panelist questioned, highlighting theโฃ difficulty of reacting to trendsโฃ in real-time.As Indurial put it,the โEOM is “a nicely designed map withoutโ a compass,” leaving oncologists without immediate insight into nationalโ drug pricing trends and their impact on trendโ factor calculations. Treatment decisions, they โemphasized,โค are still driven by patient needs, payer coverage, and โขdrug availability.
The administrative burden associated with EOM โขisโค also growingโ as โopportunities forโ performance-based payments diminish. Indurial noted the proliferation of varied programs from commercial payers and Medicare Advantage plans,โ requiring โคpractices to “navigate each one of them individually.” Despite automation efforts, โIngram stressed, “You can’t understate the manual nature” of data extraction.โ
Efforts toโ streamline reportingโ by aligning EOM with the Merit-based Incentive Payment โSystem (MIPS) haveโค faced challenges, with someโ self-selection measures proving incompatible with broader โขreporting requirements, according โtoโ Baker.
Participation numbersโฃ also reveal a shrinking program. โWhile OCM launched with over 200 practices โand โขconcluded with 122 in June 2022, EOM began with 44 and currentlyโข lists โฃ38 onโ its website. severalโข panelists indicated uncertainty about their future participation. While Ingram โฃstated his practice would remain in the program for now, Indurial’s team will “undertake a deeper look โฃat whether participation makes sense on an ongoingโ basis,” emphasizing โฃthe need toโ maintain financial โฃstability to ensure continued patient access to care. “Because โat the end of the day, we have to keep the doors open. Or else, patients don’t get care,” he concluded.
