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New CMS cancer-care program: ‘Specialty-based global payment’

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This JAMA piece looks at CMS’s plans to begin a new Medicare contracting model for pay-for-performance cancer care that “might serve as a model for specialty-based global payment.”

The article says:

The model ”allows oncologists to serve as the coordinator of the patient’s care, similar to primary care physicians in ACOs. Oncologists may be particularly well suited to assuming this role, given their longitudinal relationships with patients, continuity of oncologic treatments, and that costly episodes of care are relatively short and well defined.

“The OCM  {Oncology Care Model} may pave the way for a new phase in payment reform centered on specialty-based global budgets. Another example is the Medicare Comprehensive End-Stage Renal Disease (ESRD) Care Model, in which physicians and dialysis organizations assume responsibility for a budget for beneficiaries with ESRD. Although there are potential pitfalls of using smaller budgets, carefully designed incentives appropriately targeted to a specialty may offer a compromise between fee-for-service and wholesale risk contracts.”

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