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Starling Physicians selected to participate in a nationwide Oncology Care Model to improve quality and coordination of care

I am thrilled to announce that The Centers for Medicare & Medicaid Services (CMS) recently announced that it has selected Starling Physicians as one of nearly 200 physician group practices and 17 health insurance companies to participate in a nationwide program to improve cancer care. We will be part of a 5-year program starting July 1st that encourages higher quality, more coordinated cancer care.

For Starling to be selected to participate in the Medicare Oncology Care Model (OCM) speaks volumes to the high quality and broad capability of Starling cancer specialists in caring for patients. Participating in the Oncology Care Model takes our cancer care to the next level, allowing us to add supports that were not previously possible, and bring to life the most complete approach to a patient on his or her cancer journey.

“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.”

Improving Care…Lowering Costs

The Oncology Care Model encourages practices to improve care and lower costs through episode- and performance-based payments that reward high-quality patient care. The Oncology Care Model is one of the first CMS physician-led specialty care models and builds on lessons learned from other innovative programs and private-sector models. As part of this model, physician practices may receive performance-based payments for episodes of care surrounding chemotherapy administration to Medicare patients with cancer, as well as a monthly care management payment for each beneficiary. The two-sided risk track of this model would be an Advanced Alternative Payment Model under the newly proposed Quality Payment Program, which would implement provisions from the Medicare Access and CHIP Reauthorization Act of 2015.

“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.”

What This Means for Our Patients

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

Being in the OCM means that our patients will receive dramatic benefits of enhanced partnership during their care with us including additional nursing, social support, and coordinators to help them navigate this challenging time in their lives. Our doctors and staff will be positioned to gain an even better understanding of patient needs and respond to them even faster, with improved communication.

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/.