CMMI Refines and Extends Enhancing Oncology Model

May 31, 2024
The base Monthly Enhance Oncology Services payment amount is increased from $70 to $110 per beneficiary per month

On May 30, the Centers for Medicare & Medicaid Services announced the opening of a second round of applications to join the Enhancing Oncology Model (EOM) in July 2025. The application portal to apply will open in July 2024. 

EOM is a voluntary payment model intended to transform care for cancer patients. EOM aims to improve care coordination, quality, and health outcomes for patients while also holding oncology practices accountable for total costs of care to make cancer care more affordable, equitable, and accessible for patients and Medicare. There are 41 practices and three payers participating in the first cohort. 

The Center for Medicare & Medicaid Innovation (CMMI)  also announced several refinements to the model’s policies, including:
• Increasing the base Monthly Enhance Oncology Services (MEOS) payment amount from $70 per beneficiary per month to $110 per beneficiary per month, For dually eligible beneficiaries, the MEOS payment will increase from $110 per beneficiary per month to $140 per beneficiary per month;
• Raising the threshold for the point in which participants are required to pay back CMS to costs related to their patients’ care; and
• Extending the model by two years, until June 2030.

The Community Oncology Alliance issued a statement saying that it continues to see significant lags in data reporting, meaning practices are forced to wait long periods of time to find out how they are doing each performance period. In addition to unacceptable wait times, practices are still seeing some structural issues and are now faced with uncertainties surrounding MEOS. “While the updates from CMMI are a step in the right direction, we know the EOM can continue to evolve in a way that works better for those utilizing it day to day,” COA said. 

“We are eager to see how community oncology practices respond to these updates. COA is dedicated to new models that transform cancer care delivery and benefit patients. We will continue working with CMMI on these and other improvements to the EOM, as well as future models,” the group said. 

Sponsored Recommendations

Elevating Clinical Performance and Financial Outcomes with Virtual Care Management

Transform healthcare delivery with Virtual Care Management (VCM) solutions, enabling proactive, continuous patient engagement to close care gaps, improve outcomes, and boost operational...

Examining AI Adoption + ROI in Healthcare Payments

Maximize healthcare payments with AI - today + tomorrow

Addressing Revenue Leakage in Hospitals

Learn how ReadySet Surgical helps hospitals stop the loss of earned money because of billing inefficiencies, processing and coding of surgical instruments. And helps reduce surgical...

Care Access Made Easy: A Guide to Digital Self Service

Embracing digital transformation in healthcare is crucial, and there is no one-size-fits-all strategy. Consider adopting a crawl, walk, run approach to digital projects, enabling...