Bo Gamble, COA, Dir. of Strategic Practice Initiatives Laura Stevens, IOBS, Program Director Daniel McKellar, MD, FACS, Chair, Commission on Cancer

History of this Program

3 Oncology Medical Home History Why the need Payers (Medicare and private insurers) are demanding quality, cost control, accountability, and predictability – All are trying to quantify quality and value – Payers are teaching and learning from each other The cost of treating cancer is increasing – Payment of cancer care is at a crossroads – Every payer with a pathway is unsustainable and not good medicine The landscape of all of cancer care is changing due to unstable and unsustainable reimbursement – Leaving treatment gaps, especially in rural areas – Increasing costs

4 Oncology Medical Home History Why Accreditation  Important for validation of compliance of standards.  Assures appropriate structures and processes in place.  Provides accountability.  Promotes best practices.  Improves patient and other stakeholder confidence in the quality of care.  Identifies areas needing improvement.  Decreases variations in care.  Improves efficiency of care.

5 Oncology Medical Home History COA  Directed by the COA Board of Directors  Collaborative industry wide focus on the OMH  Resources Website Roadmap Checklists Policy and Procedure Templates Patient Education Materials Patient Satisfaction Survey/Benchmarking

6 Oncology Medical Home History COME Home Robust use of health IT systems (EMR, PMS, lab systems, etc.) Ongoing relationships with a personal oncologist to provide first contact and continuous, comprehensive care Physician-led team-based care, where every member of the team works at the top of their license Patient and Family orientation, with Patient Education on how a patient can best benefit from the new system Integrated and coordinated care with automated real-time decision support system to provide aggressive symptom management Evidence-based medicine and performance measures to assure quality and safety and generate true outcomes data Enhanced access, such as late hours and same-day appointments Enhanced payment through Medicare CMMI

7 Oncology Medical Home History How can we improve upon other models  OMH Accreditation program focuses on alignment with community oncology practice’s priorities  Domains and Standards are Oncology specific vs. the existing PCMH (Primary Care Medical Home)  Program focused on: Quality Value Outcomes

Commission On Cancer

9 Oncology Medical Home History Commission On Cancer 80 years of experience accrediting cancer programs: Comprehensive Patient-Centered standards. Leader in quality metric development and implementation. Significant infrastructure in place: Well-trained, knowledgeable staff. Trained and experienced surveyor team. Experience with data on cancer patients (NCDB). Numerous educational programs for cancer programs. National recognition for accrediting cancer programs.

10 Oncology Medical Home Our Mission and Who We Are “ The Commission on Cancer is a consortium of professional organizations dedicated to improving survival and quality of life for cancer patients through standard-setting, prevention, research, education, and the monitoring of comprehensive quality care.” 55 professional member organizations focusing on Clinical issues Advocacy Research Administrative services

11 Oncology Medical Home Progress To Date  Standards workgroup meetings for last 12 months.  Standards finalized.  Draft of standards manual completed.  Pilot practices educated on standards.  Onsite OMH accreditation visits completed: Accreditation questionnaire Policies Procedures 19 OMH Measures Discussions on workflow Chart review

12 Oncology Medical Home CoC OMH Accreditation Pilots PracticeSTDate(s) Oncology Hematology Care, CincinnatiOHFebruary 24 th Center for Cancer and Blood Disorders, Fort WorthTXFebruary 24 th Dayton Physicians NetworkOHFebruary 25 th Austin Cancer CenterTXFebruary 25 th Oncology Hematology Associates of Springfield M.D. P.C. MOMarch 3 rd Northwest Georgia Oncology CenterGAMarch 5 th Space Coast Cancer CenterFLMarch 20 th Hematology Oncology Associates of Central New York NYMarch 31 st New Mexico Oncology Hematology CenterNMApril 14 th Maine Center for Cancer MedicineMEApril 15 th

13 Oncology Medical Home Reminder…. Pilot

14 Oncology Medical Home  Eligibility Criteria Essential components of an Oncology Medical Home  Domains #1 Patient Engagement #2 Expanded Access #3 Evidence Based Medicine #4 Comprehensive Team Based Care #5 Quality Improvement Components:

15 Oncology Medical Home  Eligibility The entire cancer care team supports and promotes the OMH Certified EHR Submits date that demonstrates compliance  Domains #1 Patient Engagement – Patients educated on OMH – Financial counselors assist patients – Practice has a patient portal – Patients have access to their medical information Components:

16 Oncology Medical Home  Domains #2 Expanded Access – A new patient can easily access their OMH – An established patient can easily access their OMH #3 Evidenced Based Guidelines – Treatments are according to guidelines – Clinical trials are offered through the practice Components:

17 Oncology Medical Home  Domains #4 Comprehensive Team Based Care – The medical oncologist directs the team – The practice coordinates with other provider teams – Coordinates with other CoC programs – Psychosocial assessment and interventions – Patients receives treatment, survivorship and end of life care plans #5 Quality Improvement – Practice assures completeness of clinical data – Participates in standard patient satisfaction surveys – Quality improvement processes Components:

18 Oncology Medical Home Emphasis on…. Value

19 Oncology Medical Home Must be…. Meaningful

20 Oncology Medical Home Assistance  IT Vendors Altos Elekta FlatIron IKnowMed NantHealth Unlimited Systems  Legislation – SGR Repeal, H.R 1416  Grants – CMMI  Pilot programs w/private payers Aetna United BCBS Humana

21 Oncology Medical Home Next Steps – Lesson Learned  What cancer care team has learned from the accreditation effort.  Suggestions from the pilots on how to improve the accreditation effort  Advice from the pilots for other cancer care teams.

22 Oncology Medical Home Next Steps – Commission on Cancer  Finalize standards  Optimize survey process  Develop a business plan to ensure this is self-sustaining  Determine mechanism(s) to obtain data for quality measures  Determine interest from other practices  Engage payers-How can we make this meaningful to them?  Expand to as many as 50 more practices in 2016 

23 Oncology Medical Home Questions/Comments

An initiative for all stakeholders