CMS Announces Model Participants for the Enhancing Oncology Model (EOM)

The Center for Medicare and Medicaid Innovation (CMMI) is pleased to announce the organizations participating in the Enhancing Oncology Model (EOM). Launching on July 1, 2023, the five-year model test delivers towards the Biden-Harris Administration’s Cancer Moonshot goals, to decrease the cancer death rate by at least 50% over 25 years – saving and extending 4 million Americans lives – and to transform the experience of people who are touched by cancer and their families and caregivers.

As of June 27, 2023, 67 oncology physician group practices (PGPs) are participating in EOM. Across the 67 PGP participants, there are over 600 sites of care representing approximately 37 states nationally and over 3,000 unique practitioners. Approximately 15% of EOM participants’ sites of care are located in a rural/small town/micropolitan area, with a little over half of EOM participants having previously participated in the Oncology Care Model (OCM).

EOM builds on the successes of and lessons learned from the Oncology Care Model (OCM) and feedback from the oncology community, including, but not limited to OCM participants, patient advocacy groups, oncology professional associations, and others. The goal of EOM is to drive transformation in oncology care by preserving and enhancing the quality of care furnished to Medicare beneficiaries undergoing treatment for cancer while reducing Medicare program spending. EOM aims to improve quality and reduce costs through payment incentives and required participant redesign activities such as ensuring patients with Medicare have equitable access to navigation services and that providers discuss and develop an individualized care plan for their patients. Oncology practices that participate in EOM will take on financial and performance accountability for episodes of care surrounding systemic chemotherapy administration to patients with common cancer types.

EOM will include screening for health-related social needs (HRSNs), introduce data reports on expenditure and utilization patterns of their patient population to help health care professionals identify and address health disparities, and offer an additional payment for the provision of Enhanced Services to patients who are dually eligible for Medicare and Medicaid that is not included in the total cost of care responsibility. EOM participants will ask patients to routinely report their symptoms in order to encourage better communication and a more proactive care response, and EOM participants will be required to submit plans outlining how they will promote health equity.

For more information, please reference the EOM website at https://innovation.cms.gov/innovation-models/enhancing-oncology-model.

For questions or comments regarding EOM, please contact [email protected].

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