RTI awarded contract to implement and monitor new payment model for oncology care

The model is designed to test how to improve health care providers’ ability to deliver patient-centered care to beneficiaries undergoing chemotherapy for cancer treatment

RESEARCH TRIANGLE PARK, N.C. — As part of a new contract, RTI International, a nonprofit research institute, will implement and monitor services for an episode-based model for oncology care, the Enhancing Oncology Model (EOM).

The model was designed by the Center for Medicare and Medicaid Innovation (CMMI), part of the Centers for Medicare and Medicaid Services (CMS), to improve ability of providers to deliver patient-centered care for patients undergoing chemotherapy for cancer, consider patients’ unique needs generate the best possible patient outcomes and ultimately lower costs to the health care system.

The seven-year, $27 million task will focus on supporting chemotherapy centers as they provide whole-person care to their patients while identifying and addressing patients’ health-related social needs (such as food insecurity or transportation challenges) and potential treatment side effects (such as pain and nausea). EOM is one of CMMI’s first specialty care payment models to focus on identifying and addressing inequities based not only on race but also on gender identity, sexual orientation and primary language.

EOM supports President Joe Biden’s Cancer Moonshot initiative to improve the experience of families living with and surviving cancer and is in alignment with the CMS strategy to identify and address systemic inequities in health care.

“Patients who receive cancer diagnoses are often overwhelmed with information and emotions, which means they might be hesitant to ask questions about treatment plans or talk with their oncologist about symptoms such as depression or pain. Moreover, medical oncologists are administering potentially life-saving chemotherapy while at the same time tasked with recognizing the need for end-of-life palliative and hospice care when the time comes,” said Pamela Spain, Ph.D., EOM project director and director of Specialty Care for Seriously Ill Populations at RTI. “Our work will try to determine if a patient-centered model of cancer care such as EOM leads to higher quality and more coordinated care for patients with cancer and leads to lower costs to the Medicare program.”

Specifically, EOM aims to improve coordination across a cancer patient’s health care providers and supports personalized services that help the patient navigate and manage their cancer care. EOM participating chemotherapy centers will take into consideration their patients’ preferences and goals for treatment, health-related social needs, as well as psychosocial health needs. The purpose of EOM is for practices to design care so that patients to feel better supported in their care; have a clearer understanding of their diagnosis, prognosis, and expected outcomes; and adhere to their treatment plan, which they develop in partnership with their oncologist.

RTI brings its experience working closely with CMS since 2015 to launch the Oncology Care Model (OCM) to its implementation and monitoring of EOM.

In the last six years, OCM incentivized practitioners to improve how they provided cancer care to focus on the patient, improve or maintain quality, and avoid unnecessary costs. Similar to OCM, EOM will focus on value-based, patient-centered care for cancer patients undergoing chemotherapy based on six-month episodes of care, with a specific focus on health equity. EOM builds on the lessons learned from OCM and feedback from the oncology community.

Learn more about RTI’s health-related work