Enhancing Oncology Model

The Center for Medicare & Medicaid Innovation’s new Enhancing Oncology Model (EOM) aims to enhance the quality of care provided to cancer patients covered under Medicare Traditional while reducing Medicare fee-for-service expenditures. As a total-cost-of-care model, EOM offers a vehicle for accountable care organizations and integrated delivery networks to better align specialists with their primary care infrastructure through financial incentives, certain fraud and abuse waivers, and access to data. EOM also provides an opportunity for cancer practices to prepare for a potential future in which Medicare reimbursement for high-cost drugs is lower. However, there are financial risks associated with participation, as well as additional reporting requirements.

Learn what questions to consider when evaluating participation in our related blog post, and how the Enhancing Oncology Model can help you accelerate movement toward value-based care in our Sg2 Perspectives podcast episode 132.

Applicants must submit a nonbinding application by September 30, 2022, to preserve their opportunity to participate. Accepted organizations will make participation decisions, including risk track selection, in the spring of 2023. EOM begins July 1, 2023, and runs through June 2028.

Organizations that want to drive success in EOM will need to:

  • Understand the drivers of potentially preventable expenditures among the patient population attributed to the model
  • Identify opportunities for improvement among each of the included cancer types
  • Align EOM efforts with other organizational value-based care initiatives to advance strategic goals
  • Understand the pros and cons of the different risk tracks
  • Develop partnerships to coordinate care across the continuum
  • Execute financial arrangements with care partners
  • Develop a funds flow mechanism for Performance Based Payment

 

Models like EOM are complex and involve important decisions, but Sg2’s expertise—and experience—in value-based care can help your organization power your success across the entire life cycle of your EOM participation.

 

Help with managing total cost of care in oncology is a click away.
Request more information or to speak with an Sg2 value-based care expert.
 

Learn more about EOM through Sg2’s…

  • Expert Q&A: Our EOM experts are available to answer your questions on the new program

 

Our Experts

Tawnya Bosko, DHA    
Tawnya Bosko, DHA, PhD

Senior Principal, Sg2 Consulting
A nationally recognized expert, Tawnya Bosko partners with clients to develop successful value-based care enterprise strategies and provides program-specific guidance on financial modeling and physician-hospital alignment.

Keely Macmillan, MS    
Keely Macmillan, MS

Associate Principal, Sg2 Consulting
Keely Macmillan leads engagements that assist health care organizations’ transition to value-based payment and delivery models, partnering with provider organizations to identify and implement strategies for success in alternative payment models, including shared savings arrangements, capitation and episodic payments.

Joe Maher, CPA, MBA    
Joe Maher, CPA, MBA

Associate Principal, Sg2 Consulting
Within value-based care, Joe Maher partners with organizations to bring together advancing economic models and structures that align with the organization’s clinical care delivery approach.

William Ringwood    
William Ringwood, MBA

Senior Director, Sg2 Consulting
Bill Ringwood specializes in financial planning and forecasting for value-based care, physician alignment, managed care contracting and payer strategy initiatives.

 

Our value-based care experts also coordinate closely with our cancer service line experts for cancer service line strategy and care redesign for success in EOM and other alternative payment models. You can learn more about Sg2’s Associate Principal Cory Jones here and Principal Melissa Threlkeld, FACHE, here.