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The Oncology Institute of Hope and Innovation Exceeded Quality Standards and Saved Medicare More Than $1M in 2020

Nurse Preps Patient for IV

CERRITOS, Calif., November 1, 2021–(BUSINESS WIRE)–The Oncology Institute of Hope and Innovation (TOI), one of the largest community oncology practices in the US and one of the nation’s leading value-based oncology services platforms, saved Medicare more than $1M in 2020 as part of the Oncology Care Model (OCM) program, which equates to more than $3,000 per patient episode. This is in addition to the nearly $5M TOI has saved Medicare since the inception of the program. At the same time, TOI has continued to perform well on OCM’s Quality Measures, with above-average performance based on TOI’s aggregate quality score during the most recent reporting period (PP8). This exceptional performance again validates TOI’s track record of achieving better outcomes for patients, at lower costs.

In 2015, The Center for Medicare & Medicaid Innovation launched new payment and delivery models like OCM to improve the efficacy and efficiency of specialty care. The Oncology Care Model aimed to provide greater quality, highly coordinated oncology care at the same or lower cost to Medicare. Under the OCM, TOI entered into payment arrangements that include financial and clinical accountability for episodes of care surrounding cancer treatment. As an OCM participant, TOI provides enhanced services to Medicare beneficiaries such as care coordination, navigation, and 24/7 symptom management.

“We are extremely proud of these results and see them as validation of our approach to patient care,” remarked TOI CEO Brad Hively. “While traditional Medicare patients make up a relatively small percentage of our total patient population, we apply many of the same quality and cost-saving measures across the entire practice.”

The OCM is a natural extension of TOI’s value-based oncology care model. Staffed by a clinical team that speaks more than 20 languages, TOI offers in-house labs, transfusions, and dispensary services as well as cutting-edge treatments including an outpatient stem cell transplant program and access to more than 130 clinical trials. Believing that every patient deserves access to world-class care close to home, The Oncology Institute currently manages 50 community-based practice locations in California, Nevada, Arizona, and Florida. TOI serves approximately 1.5 million lives and treats more than 46,000 patients each year.

Disclaimer: The statements contained in this document are solely those of the authors and do not necessarily reflect the views and policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this agreement.

To read the full press release announcement, click here.