Practice radiation patterns among oncologists in the Oncology Care Model.

OBJECTIVES

CMS created the Oncology Care Model (OCM) to increase the delivery of cost-efficient cancer care, but in linking medical oncologist compensation to total costs of care, the model also prompted concerns about reductions in radiation therapy utilization. We compare practices that participated in the model with those that did not through its launch to estimate whether radiation therapy utilization was reduced under the OCM.

STUDY DESIGN

Retrospective analysis of a secondary claims-based data set.

METHODS

We used 5 years of reimbursement claims data from a large community oncology network in which approximately half of the practices participated in the OCM to measure the relative change in utilization following OCM participation compared with practices that did not participate in the OCM. We evaluated use of radiation therapy for all cancer diagnoses and, more specifically, bone metastases, lung cancer, and breast cancer to assess whether effects varied by setting using 3 quasi-experimental estimation techniques (difference-in-differences, event study, and triple differences regressions).

RESULTS

We found no evidence of reductions in radiation therapy utilization associated with the OCM between participant and nonparticipant practices in any of the specifications or subpopulations analyzed.

CONCLUSIONS

Despite the potential incentives for medical oncologists to reduce radiation therapy utilization, we found no evidence that such reduction occurred.