Specialty Payment Model Opportunities and Assessment: Oncology Simulation Report

Chapin White ; Chris Chan ; Peter J. Huckfeldt ; Aaron Kofner ; Andrew W. Mulcahy ; Julia Pollak ; Ioana Popescu ; Justin W. Timbie ; Peter S. Hussey

RAND Corporation

RAND Corporation

关键词: United States;    Modeling and Simulation;    Fee-for-Service for Health Care;    Cancer;    Medicare;    Students;   

DOI  :  10.7249/RR799
RP-ID  :  RR-799-CMS

学科分类：自然科学（综合）

美国|英语

来源: RAND Corporation Published Research

【 摘 要 】

This report describes the results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS). CMS asked MITRE and RAND to conduct simulation analyses to preview some of the possible impacts of the payment model and to inform design decisions related to the model. The simulation analysis used an episode-level dataset based on Medicare fee-for-service (FFS) claims for historical oncology episodes provided to Medicare FFS beneficiaries in 2010. Under the proposed model, participating practices would continue to receive FFS payments, would also receive per-beneficiary per-month care management payments for episodes lasting up to six months, and would be eligible for performance-based payments based on per-episode spending for attributed episodes relative to a per-episode spending target.