Transitions' Oncology Care Model Approach to Value-Based Medicine
By: Kuljit Kapur, Transitions Chief Medical Officer
Transitions Care partners with excellent oncology practices who participate in the Oncology Care Model (OCM), as outlined by the Centers for Medicare & Medicaid Services (CMS). Whether the goal is comfort or cure, excellent symptom management is delivered to our patients, transforming Oncology Centers to integrative institutes filled with compassionate and educated care. Coupled with symptom management, the Transitions OCM program achieves therapeutic relationships with patients as they meet their most critical decisions and plan for next steps of treatment. Widely accepted data speaks to the excellence of clinicians in practicing value based collaborative medicine to prevent hospitalization in seriously ill patients – on average, palliative care programs save patients $117 per day from averted hospitalizations. The continuity and care coordination of the community are key to the success of an oncology practices outcome and satisfaction.
OCM programs carry mandatory two-sided risk, and commands a responsibility to the patients in offering the right type of care at the right time. Incorporating a fluid, driven palliative care model, like ours, allows the opportunity to do the right thing for patients, and help them feel their best whether they seek comfort or cure. We practice polypharmacy which manages drug costs and maintains savings by prevention of high risk episodes and keeping patients where they want to be一home. Advanced Care Planning and access to staff 24 hours a day prevents unnecessary hospitalizations. Oncology Care First (OCF ), another new program, will go live once OCM ends and will have higher risk sharing and lower per member per month costs than the OCM. The Oncology Bundle will also start in July of 2021 and will enroll certain DRGs to manage data.
Early integration of palliative care allows for not only improved symptom management, therefore quality of life, but less aggressive end of life care and improved survival. Careful stratification of patients allows for best interventions and resource utilization. Transitions will continue to effectively follow through with the palliative care program model, ensuring our patients receive what they deserve – the best quality of care possible.