Texas Oncology was selected as a participant in the Enhancing Oncology Model (EOM), an innovative program from Centers for Medicare and Medicaid Services (CMS) designed to improve care coordination and enhance quality of care.
Texas Oncology was selected to be a participant in the program’s predecessor, the Oncology Care Model (OCM). Through participation in the Oncology Care Model, transformational changes were implemented across the practice for all patients, not only the patients affected under the OCM. We made important changes in how we communicated, planned and managed treatment, followed up, and engaged with patients throughout treatment and into survivorship. We realize that a cancer diagnosis can impact many areas of a patient’s life, and taking care of the whole person is important.
Because Texas Oncology’s culture is to do the right thing for all patients, as we implement the EOM and other value-based care models, we’re focused on doing more to help you better understand your illness and treatment, set expectations regarding side effects from treatment, and help you avoid unnecessary hospital and emergency room visits. For example, you will receive a wallet card that clearly identifies your treatment and lists specific symptoms that should prompt you to call Texas Oncology first for help.
We now carry forward the enhancements from the Oncology Care Model and bolster programs through the Enhancing Oncology Model. CMS developed the EOM program to provide higher quality, more coordinated care and reduce the cost of care to patients and Medicare. While the program focuses on Medicare patients diagnosed with seven specific cancers and undergoing chemotherapy, Texas Oncology will deliver the care enhancements that help provide value and better outcome to all patients.
Oncology Care Model Enhancements
OCM laid the foundation for more healthcare access and assessment. These included:
- Enhanced patient navigation services and follow-up after treatment.
- Greater awareness and clear instructions regarding 24/7 access to oncology teams – calling Texas Oncology first can help many patients manage pain and other symptoms and avoid ER and hospital admissions.
- Increased shared decision making with a focus on educating you about treatment choices and that includes your wishes and values.
- A written treatment plan to help you understand your diagnosis, prognosis, and treatment options.
- Expanded survivorship and advance care planning programs.
Enhancing Care Model Benefits
EOM participation focuses on continuing the integral value-based care benefits of OCM – while furthering our commitment to addressing other quality measures that impact our patients such as disease complexity, pain, depression, and social determinants of health. Through directed screening efforts, our clinical teams are able to identify barriers to care, both practical and emotional, and connect patients with our social work team when needed.
Our patients will benefit from oncology care enhancements related to the EOM, including:
- Implementation of evidenced-based screening tools to assess for diagnosis related distress and depression.
- Screening for needs related to social determinants of health with support and resource connection to address areas of need identified that may include food insufficiency, transportation barriers, financial challenges, and housing insecurity.
- Pharmacy financial specialists to support patients seeking financial assistance for any self-administered medication prescribed by Texas Oncology, including screening for eligibility and securing program enrollment for a wide variety of programs such as copay cards, vouchers, grants, manufacturer’s patient assistance programs to receive free drug, and others.
- Mental health services from licensed social workers, including clinical counseling. Bolstered community partnerships for additional behavioral health services capacity.
- Pilot program with patient resource coordinators to facilitate resource connection with community agencies and organizations.
- Expanded offering of support groups, both virtually and in person.
CMS asks that we collect patient demographic information. While optional, this important information ensures that we are able to provide inclusive and patient-centered care. If you are on Medicare and treated for one of the seven specified diagnoses, Medicare will contact you directly following six-month intervals of treatment with a survey about your experience with Texas Oncology.
Texas Oncology’s Approach to Care
Care for all patients will be enhanced through access to these additional services, regardless of treatment methods. The EOM is aligned with Texas Oncology’s patients-first, compassionate care approach and continues to emphasize collaboration among
medical oncologists, radiation oncologists, and
surgeons. While these services are already in effect, our team is always evolving and refining benefits for our patients.
As a pioneer in community-based cancer care, Texas Oncology’s participation in the EOM is another example of our commitment to leadership and innovation in improving patient care.
In addition, Texas Oncology has collaborated with health insurance providers, including Aetna and UnitedHealthcare on quality/value care models with similar objectives as the EOM, such as helping patients stay well during and after treatment, and avoid visits to the emergency room or hospital.
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