Background: It is well known that one of the biggest challenges in the OCM is being able to reduce DS. DS accounts for approximately 50% of episode costs within OCM. New Century Health (NCH) is well known for its value-based care CPs, with a history of successfully controlling DS and taking risk on behalf of commercial payors in oncology. Cancer Care Specialists of Illinois (CCSI), is a community-based oncology private practice spread throughout rural Illinois and is an OCM participant with 14 Medical Oncologists and 4 Mid-Level providers, 6 Radiation Oncologists, and 1 Urologic Oncologist. CCSI engaged NCH in a risk- based relationship to provide support and resources that will allow maximization of OCM episodic cost savings. This included utilization of NCH’s CPs. Methods: Starting in October 2017, CCSI utilized NCHs pathways for OCM attributed patients. NCH CPs were embedded in all CCSI physician computers for rapid access and reference decision making. All treatment plans were submitted in real time to NCH for CP adherence measurement. Analysis was conducted prior to implementation and on an ongoing daily & weekly basis to identify higher cost drugs or regimens. A joint CCSI/ NCH clinical data governance committee met bi-weekly to review CP performance metrics and drug utilization. The goal was to encourage treatment choices favoring both efficacy and value. Results: Post analysis revealed that over a 15-month period (Oct 2017 to Jan 2019), a 13.5% reduction in overall DS, which is equivalent to ~$250k per physician was achieved. This contributed to an overall reduction in total cost of care by 5% as compared to the OCM median. Post analysis also revealed an increase in pathway adherence from a baseline of 69% to 81% at the end of the measurement period. Conclusions: Reduction in DS is possible within a VBC model, through the use of value-based CPs. Important factors contributing to the reduction in DS include physician adherence rates, real time identification of high cost drugs/regimens, availability of immediate peer to peer discussion, rapid desktop access to a catalog of higher value alternate therapies, and continuous collaboration between CCSI and NCH through the governance committee.