Medicare Selects Florida Cancer Specialists for Oncology Care Model

New Initiative Aims to Improve Cancer Care Nationwide

 

Fort Myers, FL – July 5, 2016……… Florida Cancer Specialists & Research Institute (FCS) is among a select group of oncologists nationwide chosen by the Centers for Medicare and Medicaid Services (CMS) to participate in the agency's Oncology Care Model (OCM). The initiative is an innovative new care delivery model that supports and encourages higher quality, more coordinated cancer care for patients undergoing chemotherapy.

Cancer is one of the most common and devastating diseases in the United States: more than 1.6 million new cases of cancer will be diagnosed and cancer will kill an estimated 600,000 Americans in 2016. According to the National Institutes of Health, based on growth and aging of the U.S. population, medical expenditures for cancer in the year 2020 are projected to reach at least $158 billion (in 2010 dollars) – an increase of 27 percent over 2010. A significant proportion of those diagnosed are over 65 years old and Medicare beneficiaries.

“The Oncology Care Model encourages greater collaboration, information sharing, and care coordination, so that patients get the care they need, when they need it,” said Health and Human Services Secretary Sylvia M. Burwell. “This patient-centered care model fits within the Administration’s dual missions for delivery system reform and the White House Cancer Moonshot Task Force – to improve patient access to and the quality of health care while spending dollars more wisely.”

“We welcome the opportunity to partner with CMS through this new initiative,” said Florida Cancer Specialists CEO Brad Prechtl. “As healthcare costs continue to rise, it is incumbent upon us all to develop programs that focus on accountability and ensure clinically excellent, compassionate, and cost-effective care in a community setting for our patients who are Medicare beneficiaries.”

Practices participating in the five-year Oncology Care Model will provide treatment following nationally recognized clinical guidelines for beneficiaries undergoing chemotherapy, with an emphasis on person-centered care. They will provide enhanced services to beneficiaries who are in the Oncology Care Model to help them receive timely, coordinated treatment. These services may include:

 

  • Coordinating appointments with providers within and outside the oncology practice to ensure timely delivery of diagnostic and treatment services;

  • Providing 24/7 access to care when needed;

  • Arranging for diagnostic scans and follow up with other members of the medical team such as surgeons, radiation oncologists, and other specialists support the beneficiary through their cancer treatment;

  • Making sure that data from scans, blood test results, and other tests are received in advance of patient appointments so that patients do not need to schedule additional visits; and

  • Providing access to additional patient resources such as emotional support groups, pain management services, and clinical trials.

 

“We have been diligently working for the past year to prepare for the opportunity to partner with our largest payer partner, Medicare”, said Florida Cancer Specialists Chief Revenue Cycle Officer Sarah Cevallos. “As the healthcare payment models continue to evolve, innovative care delivery models like the OCM will permit practices with the ability to provide even greater opportunities to deliver the highest level of care for our patients with cancer.”

FCS President and Founder Dr. William Harwin added, “Excellence in cancer care requires physicians to comprehensively address the extremely complex needs of our patients. The Oncology Care Model proposed by Medicare is consistent with our current approach and includes a focus on those patients who are undergoing chemotherapy, which has always been a priority for FCS.”

“CMS is thrilled with how many physician groups chose to be a part of the Oncology Care Model,” said Patrick Conway, M.D., CMS principal deputy administrator and chief medical officer. “We have nearly doubled the number of participants that we anticipated. It’s clear that oncology physicians recognize the importance of this new performance-based, episode-based payment approach to cancer care. As a practicing physician and son of a Medicare beneficiary who died from cancer, I know the importance of well-coordinated care focused on the patient’s needs.”

The names of those practices and payers participating in the Oncology Care Model, and more information about the model, can be found on the model’s website: http://innovation.cms.gov/initiatives/Oncology-Care/. The Oncology Care Model begins on July 1, 2016 and runs through June 30, 2021.

As part of the Administration’s “better care, smarter spending, healthier people” approach to improving health delivery, the Oncology Care Model is one of many innovative payment and care delivery models developed by the CMS Innovation Center and advanced by the Affordable Care Act. The Innovation Center is committed to transforming the Medicare, Medicaid and Children’s Health Insurance Program (CHIP) programs and is expected to help deliver better care for individuals, better health for populations, and lower growth in expenditures for Medicare, Medicaid and CHIP beneficiaries.