Commentary: Quality nutrition care is integral to the Oncology Care Model

Abstract

The Oncology Care Model (OCM) is a US Centers for Medicare & Medicaid Services (CMS) specialty model implemented in 2016, to provide higher quality, more highly coordinated oncology care at the same or lower costs. Under the OCM, oncology clinics enter into payment arrangements that include financial and performance accountability for patients receiving chemotherapy treatment. In addition, OCM clinics commit to providing enhanced services to Medicare beneficiaries, including care coordination, navigation, and following national treatment guidelines. Nutrition is a component of best-practice cancer care, yet it may not be addressed by OCM providers even though up to 80% of patients with cancer develop malnutrition and poor nutrition has a profound impact on cancer treatment and survivorship. Only about half of US ambulatory oncology settings screen for malnutrition, registered dietitian nutritionists (RDNs) are not routinely employed by oncology clinics, and the medical nutrition therapy they provide is often not reimbursed. Thus, adequate nutrition care in US oncology clinics remains a gap area. Some oncology clinics are addressing this gap through implementation of nutrition-focused quality improvement programs (QIPs) but many are not. What is needed is a change of perspective. This paper outlines how and why quality nutrition care is integral to the OCM and can benefit patient health and provider outcomes.

Early identification of cancer-related malnutrition in patients with colorectal cancer before and after surgery: a literature review

“…Despite this scientifically verified knowledge, summarized in the European Society for Parenteral and Enteral Nutrition (ESPEN) guidelines on nutrition in cancer patients [2], there is a need for improvement, as cancer-related risk of malnutrition is still too often not assessed [7] and, therefore not noticed early enough by health professionals, is overlooked or not treated adequately [4]. A recent survey found that up to 43% of clinicians (dietetic, nursing, medical) have limited or no confidence in their ability to detect malnutrition and sarcopenia [8].…”