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CMS Oncology Care Model selects Smilow Cancer Hospital

Thursday, June 30, 2016

NEW HAVEN, CT (June 30, 2016) – The Centers for Medicare & Medicaid Services (CMS) today announced that it has selected Smilow Cancer Hospital at Yale New Haven/Yale Cancer Center as one of nearly 200 physician group practices and 17 health insurance companies to participate in a care delivery model that supports and encourages higher quality, more coordinated cancer care. The Medicare arm of the Oncology Care Model includes more than 3,200 oncologists and will cover approximately 155,000 Medicare beneficiaries nationwide.

“Our participation in the Oncology Care Model will provide us with the impetus to take a most significant step toward value-based medicine at Smilow Cancer Hospital. It will allow us to institute clinical pathways dedicated to urgent care and to ensure accountable cancer care throughout our entire health system,” said Rogerio Lilenbaum, MD, chief medical officer for Smilow Cancer Hospital at Yale New Haven and professor of Medicine (Medical Oncology) at Yale Cancer Center.

Cancer is one of the most common and devastating diseases in the United States. According to the National Institutes of Health, based on growth and aging of the U.S. population, medical expenditures for cancer in the year 2020 are projected to reach at least $158 billion (in 2010 dollars) – an increase of 27 percent over 2010. A significant proportion of those diagnosed are over 65 years old and Medicare beneficiaries.

“The Oncology Care Model encourages greater collaboration, information sharing, and care coordination, so that patients get the care they need, when they need it,” said Health and Human Services Secretary Sylvia M. Burwell. “This patient-centered care model fits within the Administration’s dual missions for delivery system reform and the White House Cancer Moonshot Task Force – to improve patient access to and the quality of health care while spending dollars more wisely.”

The Oncology Care Model, announced yesterday by Vice President Joe Biden, encourages practices to improve care and lower costs and reward high-quality patient care. The Oncology Care Model is one of the first CMS physician-led specialty care models and builds on lessons learned from other innovative programs and private-sector models. As part of this model, physician practices may receive performance-based payments for episodes of care surrounding chemotherapy administration to Medicare patients with cancer, as well as a monthly care management payment for each beneficiary. The two-sided risk track of this model would be an Advanced Alternative Payment Model under the newly proposed Quality Payment Program, which would implement provisions from the Medicare Access and CHIP Reauthorization Act of 2015.

Practices participating in the five-year Oncology Care Model will provide treatment following nationally recognized clinical guidelines for beneficiaries undergoing chemotherapy, with an emphasis on person-centered care. They will provide enhanced services to beneficiaries who are in the Oncology Care Model to help them receive timely, coordinated treatment.

Smilow Cancer Hospital at Yale New Haven is part of the nationally recognized Yale New Haven Hospital, and is affiliated with Yale Cancer Center (YCC), one of only 51 National Cancer Institute (NCI)-designated comprehensive cancer centers in the nation and the only such center in Connecticut. Smilow Cancer Hospital, the most comprehensive cancer facility in New England, includes private inpatient rooms, multidisciplinary outpatient treatment centers, 12 operating rooms, infusion suites, diagnostic imaging services, and specialized women's and children’s services. Smilow Cancer Hospital also operates a dozen outpatient care centers across Connecticut. YCC and Smilow Cancer Hospital are members of the National Comprehensive Cancer Network (NCCN), an alliance of 28 cancer centers in the U.S., whose mission is to improve the quality, effectiveness and efficiency of oncology care. www.ynhh.org/smilow.

Yale Cancer Center (YCC) is one of only 49 National Cancer Institute (NCI-designated comprehensive cancer) centers in the nation and the only such center in southern New England. Comprehensive cancer centers play a vital role in the advancement of the NCI’s goal of reducing morbidity and mortality from cancer through scientific research, cancer prevention, and innovative cancer treatment. yalecancercenter.org

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