Biden Administration Announces New
Model to Improve Cancer Care for Medicare Patients
Today,
the Biden Administration, through the U.S. Department of Health and
Human Services and the Centers for Medicare & Medicaid Services
(CMS), announced a new model aimed at improving cancer care for
Medicare patients and lowering health care costs. CMS’ Center for
Medicare and Medicaid Innovation (Innovation Center) designed the
Enhancing Oncology Model (EOM) to test how to improve health care
providers’ ability to deliver care centered around patients, consider
patients’ unique needs, and deliver cancer care in a way that will
generate the best possible patient outcomes. The model will focus on
supporting and learning from cancer patients, caregivers, and cancer
survivors, while addressing inequities and providing patients with
treatments that address their unique needs. This new model
supports President Joe Biden’s Unity Agenda and Cancer Moonshot initiative to
improve the experience of people and their families living with and
surviving cancer.
“No
one should have to battle cancer without access to high quality,
coordinated care,” said HHS Secretary Xavier Becerra. “With this new
Innovation Center model for oncology care, we are delivering on President
Biden’s call to action to mobilize every option to address cancer, and
creating a system of care that supports all patients and their
families. We will continue to do all we can to make access to this care
equitable and end cancer as we know it.”
“There
are stark inequities in the ability of people with cancer across race,
gender, region, and income to access cancer screening, diagnostics, and
treatment,” said CMS Administrator Chiquita Brooks-LaSure. “CMS is
working to advance President Biden’s Cancer Moonshot goals by helping
Medicare cancer patients better navigate a challenging and often
overwhelming journey. The Enhancing Oncology Model will incentivize
participating oncology practices – including those in rural and
underserved areas – to improve the provision of high quality,
coordinated care that addresses patients’ social needs and improves
patient and caregiver support.”
The
central goal of EOM is to better support patients and improve their
care experience, advancing a key goal of the Cancer Moonshot
Initiative. Oncology practices who participate in EOM can expect to
provide patient-focused Enhanced Services, such as 24/7 access to a
clinician, patient navigation services, a detailed care plan, and
screenings for health-related social needs. Patients will also have an
opportunity to share feedback on their overall cancer care experience
and health outcomes. EOM aims to increase and improve communications
among patients, oncologists, and care teams in-between appointments and
enable patients to more easily reach their health care providers with
questions.
In
addition to requiring participants to screen for health-related social
needs, EOM includes other design elements that help drive CMS’
commitment to advancing health equity, including:
- Offering an additional
payment to participating oncology practices that provide Enhanced
Services to patients who qualify for both Medicare and Medicaid,
- Requiring participating
providers to report patient demographic data (e.g., race,
ethnicity, language, gender identity), and
- Requiring participating
providers to develop plans showing how they will address health
equity gaps in their patient population.
President
Biden has reignited the Cancer Moonshot and set new
national goals: if we work together, we can cut the death rate from
cancer by at least 50% over the next 25 years, and improve the
experience of people and their families living with and surviving
cancer — and, by doing this and more, end cancer as we know it today.
Earlier
this month, HHS announced first-year funding awards of $215 million in
a five-year, $1.1 billion investment into
three national programs to prevent and control cancer. In May, HHS
announced the availability of $5 million for
community health centers, funded by HHS’ Health Resources and Services
Administration, to increase equitable access to life-saving cancer
screenings.
A
fact sheet on EOM is available at: https://www.cms.gov/newsroom/fact-sheets/enhancing-oncology-model
For
oncology practices interested in participating in EOM, the Request for
Applications is available at: https://app.innovation.cms.gov/EOM.
All EOM applications must be submitted by 11:59 pm Eastern
Daylight Time on September 30, 2022.
More
information on the Enhancing Oncology Model is available at: https://innovation.cms.gov/innovation-models/enhancing-oncology-model.
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