AJMC June 19, 2021
Medicare value-based care programs are under great scrutiny to ensure that they can drive demonstrable savings and quality improvement. Adoption of higher-value biosimilar drugs by participants in Medicare’s Oncology Care Model (OCM) could drive the pilot program closer to its goal of generating net savings to Medicare.1
Oncology practices participating in the OCM are responsible for the quality and total cost of care—including drug spending and inpatient admissions—for their patients receiving chemotherapy.1
Drug spending constitutes approximately two-thirds of the program’s total spending.2 Part B drug spending alone accounts for about 45% of OCM spending.2 The most recent program evaluation, published in January 2021, included data from 6-month episodes triggered through January 1, 2019 (performance periods [PPs] 1-5), and found that...
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