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OCM PP1 True Up 1/PP2 Initial Reconciliation—Lessons Learned

By: Alyssa Dahl

DataGen was recently featured on www.ajmc.com.

 

More than 2 years into the Oncology Care Model (OCM) program, cohort participants still lack clarity on the program results and how they got there. CMS recently released the OCM performance period 1 (PP1) true-up 1, encompassing 8 months of data after the end of the first performance period, and the performance period 2 (PP2) initial reconciliation, encompassing 2 months of data after the end of the second performance period. The performance data show some practices may be gaining traction with their success, while others have found it difficult to make progress as CMS continues to refine the payment methodology for the model across performance periods.

Two Steps Forward, 2 Steps Back

While some of the participating practices qualified for a performance-based payment (PBP) in the initial reconciliation, they lost it in the PP1 true-up. There were several factors at play here:

 

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