Good news for patients, providers and OCM participants: CMS is “dead serious about interoperability”

userOncology Care Model

Last week at the J.P. Morgan Annual Health Care Conference, CMS Acting Administrator Andy Slavitt announced that going forward, rewards for providers will be less about the use of technology and more about the outcomes they achieve with their patients. One way to do this, he explained, is to level the playing field by requiring open APIs (application program interfaces).

“And finally”, Mr. Slavitt added, “we are dead serious about interoperability.”

This is great news for patients and for providers. And in the world of cancer care, it bodes especially well for practices planning to participate in the Oncology Care Model (OCM).

For patients, open APIs will bring the capacity to readily integrate and consolidate personal health information across care providers, clinics and geographies. Patients will at last have the ready access to their comprehensive health records that a consumer in today’s digitized world would reasonably expect. Open APIs will spur innovation and revolutionize product development in patient-facing technologies. They will give patients the ability to readily grant others access to their personal health information, at their own discretion and via the application of their choosing.

With open APIs, providers too will have the freedom to choose best-of-breed technologies, in contrast to being dependent on suboptimal software from their EHR vendors. And interoperable EHRs will not only save providers the time spent today printing and scanning documents and inputting duplicate entries into disparate systems; it will allow them to fully use the wealth of data now amassing to learn about best practices and national benchmarks, and meet the requirements of value-based payment models.

For cancer care providers in particular, hearing this commitment now from CMS lines up well with the start of OCM later this year.

OCM is a payment reform program designed to promote better care at lower costs for cancer patients undergoing chemotherapy. Oncology practices participating in OCM will have the potential of earning an average of 12% shared savings, a figure which could amount to $16,000 per beneficiary per year.

Because many of the 32 OCM quality measures require that data from 3rd parties be managed on a timely basis, interoperability will be crucial. CMS will provide claims data to OCM practices, but this is typically months old by the time it is available. Thus, to be successful in OCM, cancer practices will need to be able to share data with other practices in a timely fashion.

A “dead serious” commitment from CMS around interoperability means bringing to life the healthcare technology solutions that will lead to better outcomes, and better experiences along the way.