Currently submitted to: JMIR Cancer
Date Submitted: Mar 9, 2026
Open Peer Review Period: Mar 17, 2026 - May 12, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Oncology Care Model and Health Care Competition: A Retrospective Cohort Study
ABSTRACT
Background:
The Oncology Care Model aims to improve the value of oncology care. However, concerns exist that the Oncology Care Model participation could accelerate consolidation among smaller oncology practices, threatening market competition.
Objective:
To evaluate whether participation in the Oncology Care Model is associated with changes in oncology market competition across U.S. regions, using the Herfindahl–Hirschman Index to assess competition within Dartmouth Health Referral Regions.
Methods:
A cross-sectional analysis was conducted using Medicare claims data to identify oncology practices participating in the OCM. Market competition was assessed using the Hirschman-Herfindahl Index (HHI) across Dartmouth Health Referral Regions (HRRs) from 2015 to 2019. Demographic and socioeconomic factors were incorporated using American Community Survey data.
Results:
Market competition, as measured by HHI, remained stable from 2015 to 2019 across regions with varying levels of OCM adoption, indicating no significant impact on competition. Patient demographics and area-level socioeconomic factors minimally influenced HHI trends.
Conclusions:
The findings suggest that OCM adoption does not drive significant practice consolidation. This supports the OCM as a model that enables both smaller and larger practices to deliver high-value, patient-centered oncology care without undermining market competition. Clinical Trial: Not applicable
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