ACRO Alert Regarding Enhancing Oncology Model (EOM)

On June 27, 2022, the Center for Medicare & Medicaid Innovation (CMMI) released a new voluntary model entitled, “Enhancing Oncology Model.” This new model appears to be the next generation of the “Oncology Care Model,” which began on July 1, 2016 and will be tested through June 30, 2022. The Enhancing Oncology Model (EOM) similarly will be tested on a five-year basis, starting on July 1, 2023 and ending on June 30, 2028.  

The EOM includes Medicare fee-for-service beneficiaries receiving Part B or Part D chemotherapy for one or more of the following cancer types: breast cancer, chronic leukemia, small intestine/colorectal cancer, lung cancer, lymphoma, multiple myeloma, and prostate cancer. While the EOM builds on the Oncology Care Model (OCM), there are key differences in the models. These include (1) an explicit focus on health equity, (2) required downside risk for participants at the state of the model, (3) a differential payment based on the beneficiary’s dual eligibility status, (4) a cancer-type specific approach to calculating benchmark, and (5) the gradual requirement to use electronic patient reported outcomes. A more detailed comparison of the OCM and EOM models is provided below. 

It’s worth noting that the EOM also is a distinct model from the “Radiation Oncology (RO) Model.” As ACRO noted in a previous alert, on April 6, 2022, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to delay the current start date of the RO Model to a date to be determined through future rulemaking. That final rule has yet to be published. 

CMS does expect that there would be beneficiaries who qualify to be under both the EOM and RO Model and notes that the agency plans to align the EOM overlap methodology similar to the approach contemplated in the OCM. For example, if a 6-month EOM episode includes an entire RO Model episode (90 days of RT services) then the EOM performance period episode expenditures will include the associated RO Model payments for RT services. 

Click here for a comparison of OCM to EOM by Select Model Features.

Additional information about the new model is available here: 
https://innovation.cms.gov/innovation-models/enhancing-oncology-model  

Please note: An EOM Overview Webinar is scheduled for today, Thursday, June 30 from 3:00-4:30 pm EST. Click here to register.