CMS Oncology Care Model Names NCCN Guidelines as High-Quality Care and Evidence-Based Recommendations
Centers for Medicare & Medicaid Services encourages concordance to NCCN Guidelines for Medicare patients in order to achieve better care, smarter spending, and healthier people.
FORT WASHINGTON, PA — On Thursday, February 12, 2015, Centers for Medicare & Medicaid Services Innovation (CMS Innovation Center) announced an Oncology Care Model (OCM) with the goal to utilize appropriately aligned financial incentives to improve care coordination, appropriateness of care, and access to care for beneficiaries undergoing chemotherapy.
To participate in the OCM, participating practices will be required to treat patients with therapies consistent with nationally recognized clinical practice guidelines, such as those published by the National Comprehensive Cancer Network® (NCCN®) and American Society of Clinical Oncology (ASCO), reporting both when patients are and are not treated in concordance with such recommendations. One reason for deviation from clinical guidelines, according to CMS, is participation in a clinical trial. Participation in clinical trials is considered concordant care with the recommendations in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®).
“NCCN applauds CMS Innovation Center’s new payment and delivery model as it directly aligns with the NCCN mission to improve the quality, effectiveness, and efficiency of cancer care so that patients can live better lives,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “Today, NCCN publishes the most comprehensive, transparent, and current clinical practice guidelines in oncology, providing clinicians and patients with evidence-based recommendations in order to make informed choices relating to cancer care.”
“The decision to endorse NCCN Guidelines indeed further establishes CMS’ identification of NCCN as an arbiter of high value oncology care, adding to their recognition of the NCCN Drugs & Biologics Compendium as an authoritative reference for oncology policy coverage,” said Dr. Carlson.
According to CMS, a majority of the 1.6 million people diagnosed with cancer each year in the United States are over the age of 65 and Medicare beneficiaries; through OCM, CMS strives to achieve three goals for that population: better care, smarter spending, and healthier people.
“For 20 years, NCCN has convened multidisciplinary experts from the nation’s top cancer centers to promote the importance of continuous quality improvement,” said Dr. Carlson. “NCCN Guidelines recommendations are the standard of oncology care in the United States, and we encourage practices to participate in OCM and further high-value, evidence-based cancer treatment.”
NCCN publishes a library of 60 NCCN Guidelines®—a comprehensive set of guidelines detailing the sequential management decisions and interventions that currently apply to 97 percent of cancers affecting patients in the United States. In addition, separate guidelines provide recommendations for some of the key cancer prevention and screening topics, as well as supportive care and age-related considerations. The NCCN Drugs & Biologics Compendium (NCCN Compendium®), a derivative of the NCCN Guidelines, is recognized by public and private insurers alike, including, but not limited to CMS, as an authoritative reference for oncology coverage policy.
For more information about the NCCN Guidelines, visit NCCN.org.
About the National Comprehensive Cancer Network
The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 25 of the world’s leading cancer centers devoted to patient care, research, and education, is dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers.
The NCCN Member Institutions are: Fred and Pamela Buffett Cancer, Omaha, NE; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women’s Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Cancer Institute, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Mayo Clinic Cancer Center, Phoenix/Scottsdale, AZ, Jacksonville, FL, and Rochester, MN; Memorial Sloan Kettering Cancer Center, New York, NY; Moffitt Cancer Center, Tampa, FL; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, OH; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children’s Research Hospital/The University of Tennessee Health Science Center, Memphis, TN; Stanford Cancer Institute, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UC San Diego Moores Cancer Center, La Jolla, CA; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Colorado Cancer Center, Aurora, CO; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; The University of Texas MD Anderson Cancer Center, Houston, TX; Vanderbilt-Ingram Cancer Center, Nashville, TN; and Yale Cancer Center/Smilow Cancer Hospital, New Haven, CT.
 "Oncology Care Model Frequently Asked Questions." Centers for Medicare & Medicaid Services. Web. Accessed 13 Feb. 2015.<http://innovation.cms.gov/Files/x/ocmfaqs.pdf>.
 "Oncology Care Model (OCM) Request for Applications (RFA)." Centers for Medicare & Medicaid Services. Web. Accessed 13 Feb. 2015.<http://innovation.cms.gov/Files/x/ocmrfa.pdf>.
Katie Kiley Brown, NCCN