By Hannah Burke
In 2016, the Center for Medicare & Medicaid Innovation (CMMI) developed the Oncology Care Model (OCM), a national payment program that provides high-caliber, efficiently managed cancer care at a lower price to Medicare beneficiaries.
FCS has been enrolled in the program since its inception, and according to CMMI’s most recent OCM reconciliation data, has once again been ranked at the top among the 126 participating oncology practices across the country.
With its community-based and personalized practices, state-of-the-art clinical trial offerings and dedication to offering patients individualized, world-class cancer care, FCS’s ranking comes as no surprise to FCS Chief Executive Officer Nathan H. Walcker.
“Our value-based practice initiatives at FCS are programmatic, intentional and thoughtfully designed to be organized squarely around the patient, yielding consistent results that outpace industry benchmarks and make good on our commitment to prioritize patient outcomes and quality,” Walcker said.
“I could not be prouder of our entire team and their steadfast commitment to delivering value-based oncology care in communities across Florida.”
FCS provides care for more than 22,000 OCM beneficiaries annually and has recorded more than $140 million in Medicare savings since 2016. In the last six-month performance period of 2021, FCS saved Medicare $31.7 million.
Participation in OCM, said FCS Director of Value-Based Care TR Strickland, has allowed FCS to make “substantial strides and investments in our strategic focus on value-based programs.” FCS has succeeded in partnering with Accountable Care Organizations (ACOs), Managed Service Organizations (MSOs) and commercial/Medicare Advantage payers across our Florida markets to continue reducing care costs and prioritizing patient satisfaction.
FCS embodies all the values engaged by the spirit and the goals of the OCM demonstration initiative, which aims to not only cut costs, but more importantly, incentivize and promote enhanced systems and processes that promote “better care, smarter spending and healthier people,” according to the CMMI website. This is in essence the overriding goal of the Triple Aim for all of healthcare delivery.
FCS consistently reports on upwards of 50 quality-of-care metrics per performance period to help measure OCM effectiveness. Of those 50, FCS received exceptional scores in the areas of pain assessment, emergency room visits/inpatient hospital stays, prevention/screenings, appropriate utilization of hospice and patient-reported experience, and patient satisfaction.
CMMI’s most recent report also shows that FCS hospital admissions were 8% lower than those of other OCM-enrolled practices and, in that same period, FCS had 21% fewer cases of emergency room visits not leading to admission.
FCS Chief Medical Officer for Therapeutics & Analytics Lucio Gordan, MD attributes the organization’s success with OCM and other value-based programs to prioritizing a “well-built” infrastructure.
“At FCS, our guiding principle is to put the patient first in everything we do; we are laser-focused on providing world-class cancer care while reducing the overall cost of that care for our patients,” Gordan said. “In the long run, quality care doesn’t increase costs, as quality delivered at the right time in the most appropriate venue, often decreases overall costs and prevents adverse events.”
FCS will continue to leverage OCM value principles and infrastructure and expand the scope of its own value-based care programs to support the long-term objective of consistent, high-quality treatment. To do so we continuously refine our patient education libraries, supplies, expanded resources for after-hours symptom management, and ancillary services like nutritional health and behavioral health to improve access and reduce care costs through the use of generic and biosimilar drugs when possible.
“Simply put, exceptional, value-based cancer care centered around our patients and within their own communities and support systems is the core of our organizational mission and a fixed focus we will never waver from,” Walcker said.