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OCM Performance Period One Initial Reconciliation

By: Darcie Hurteau and Alyssa Dahl

DataGen was recently featured on www.ajmc.com.

CMS has released the first round of reconciliation data from the Oncology Care Model (OCM) bundled payment program. Interestingly, some of the practices that did well were surprised to learn they they’d achieved savings, and some participants were pleased to find out that their level of performance met expectations.

CMS has released the first round of reconciliation data from the Oncology Care Model (OCM) bundled payment program. As we at DataGen parsed through the information, we found that some of the practices that did well were surprised to learn they they’d achieved savings, and that some participants were pleased to find out that their level of performance met expectations.

It’s possible to chalk this lack of clarity up to the ongoing growing pains of a complicated payment program that’s still establishing administrative processes. CMS had to rerelease claims data twice, after they realized they weren’t sharing the exact set of claims they used for calculating the reconciliation. CMS wasn’t aware of these errors until DataGen (and probably other organizations) alerted them to the fact that claim lines were missing, and demonstrated specific instances where we couldn’t recreate the expenditures CMS reported for episodes. Since this was the first reconciliation, CMS may not have realized the data that would be required for participants to understand the reconciliation and trust the results.

To read more of this story, please visit www.ajmc.com.
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