About Janet Serluco, Vice President, Access Experience Team, PRECISIONvalue

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So far Janet Serluco, Vice President, Access Experience Team, PRECISIONvalue has created 6 blog entries.

2024 Update on the Enhancing Oncology Model (EOM)

One year after the end of the Center for Medicare and Medicaid Innovation’s multiyear Oncology Care Model (OCM), its successor program, the Enhancing Oncology Model (EOM), began on July 1, 2023. EOM is a voluntary 5-year model in which oncology practices assume risk and accountability for their Medicare patients’ health quality and total spend during 6-month episodes of care. Episodes begin with initiation of systemic chemotherapy for the 7 cancer types in which the Centers for Medicare and Medicaid Services (CMS) saw the greatest reductions in total episode payments under OCM: high-risk breast cancer; lung, prostate, and small intestine/colorectal cancer; lymphoma; chronic leukemia; and multiple myeloma.

Hospital at Home Care Models

Janet discusses the growing hospital at home (H@H) care movement that ramped up during COVID. She reflects on how hospitals will adjust to this new trend and its financial sustainability, as well as how it fits into the value-based care landscape. Finally, she presents opportunities for pharmaceutical companies to engage in this new care delivery model.

Medicare Advantage Outpaces Traditional Fee-for-Service (FFS) Enrollment: Implications

On June 15, 2022, the Supreme Court of the United States (SCOTUS) ruled in favor of hospitals over Medicare regarding a 340B reimbursement policy instituted in 2018 and unanimously decided that the almost 30% in cuts to Medicare outpatient drug payments for hospitals participating in the 340B drug pricing program was unlawful.

The Next Steps in the Oncology Care Model (OCM) – Potential Implications and Opportunities

The OCM was a 5-year voluntary advanced payment model that the Centers for Medicare and Medicaid Services (CMS) developed through the Innovation Center (CMMI) beginning July 1, 2016. CMS changes to advanced payment models due to the COVID-19 Public Health Emergency turned it into a 6-year model, which ended June 30, 2022.

Trends Impacting Access: Cancer Care and Gene Therapies–Innovative Payment Models for High-Cost Therapies

Janet Serluco addresses trends impacting access in cancer care and the innovative payment models being considered to pay for these high-cost therapies, as well as the need to focus on value of therapies in the oncology and gene therapy space to support access and reimbursement.

Oncology Coverage Policies: How to Help Payers Stay Ahead of the Scientific Curve

Janet Serluco, Vice President, Director, Payer Access Solutions, highlights the tremendous activity in oncology drug development. With 16 new oncology drugs approved by the FDA in 2017 alone, what strategies are payers adopting in future budget planning, and how do payers keep up with new oncology agents and expanding indications?