Time trends of Part D drug expenses and Part D risk adjustment in the Oncology Care Model at a community oncology network.

72 Background: The Oncology Care Model (OCM) was a 6-year Medicare value-based care (VBC) program that rewarded practices for providing high-quality cancer care to Medicare beneficiaries receiving system anti-cancer therapy, while decreasing Total Cost of Care (TCOC) compared to a benchmark price. TCOC in the model was driven by drug expenses and included both physician-administered (Part B) and prescription (Part D) medications. The past decade has seen several novel oral anti-cancer drugs revolutionize cancer treatment. The impact of the shift to oral anti-cancer drugs, the associated costs, and risk adjustments in the OCM is studied here. Methods: Using Medicare episodes data for 15 practices in The US Oncology Network (The Network) participating in the OCM, we evaluated the time trends of Part D drug expenses between July 2016 and June 2022, assessed the risk adjustment for episodes with and without Part D, and studied impacts on TCOC & benchmark prices. Results: Mean per episode spending at The Network practices increased 16.4% (3.4% CAGR) driven by a mean Part D expense per episode increase of 59% (8% CAGR) from 2016 ($5,532) to 2022 ($8,796) for OCM beneficiaries. Much