Transitioning from the CMS Oncology Care Model (OCM) to the Merit-based Incentive Payment System (MIPS)

After more than five years, the Oncology Care Model (OCM) is scheduled to come to an end when the final performance period ends in June 2022, with no new model plan in place. This will leave former OCM practices and physicians subject to the Merit-based Incentive Payment System (MIPS). 

As we’ve mentioned in recent blog posts, the stakes have never been higher than in 2022, where a total of 75 out of 100 MIPS points must be earned just to avoid a penalty. Thankfully, there are aspects of the former OCM initiative that are similar to MIPS.

OCM participants were required to report the Promoting Interoperability category, so this is where they will experience the least change. However, participants will need to make sure they’re up-to-date on the new SAFER guidelines. Understanding how to complete that exercise will be important for everyone this year and going forward. 

Tracking quality measures was an important part of the OCM and will remain a large focus in the MIPS program. Oncology practices will need to review and select six measures to track through their EHR, registry, specialized registry or combination thereof. The main challenge will be to find measures that make sense for the organization’s physicians, patient population, and keeping an eye on each measure’s point potential. 

The Improvement Activities category is one in which Oncology practices will need to familiarize themselves. The number of activities reported is based on practice size. In order to receive credit for each activity, more than 50% of all of the eligible clinicians within the TIN must participate. It's also important to pay attention to the data validation needs of this category.

Navigating the Cost category in Oncology can be tricky. It will be important to review past years' data for historical reference. There are strategies to navigate this category with success so becoming acquainted with the measures is key.

If you were a former participant in the Oncology Care Model and are now in need of expert help with the MIPS program, give us a call or email us.

Chirpy Bird provides dedicated regulatory consultants on a monthly subscription basis to help you achieve success in value-based care.