The Community Oncology Conference April 23, 2014 Oncology Payment Reform Tammy Chambers Director of Contracting The Center for Cancer and Blood Disorders

Current Payer Initiatives Aetna Oncology Patient Centered Medical Home United Episode Program – Phase I & II CMMI Come Home ACO ?OCM

If you are participating in some type of payer initiative listed below, please select all that apply: 1. Oncology Medical Home 2. Accountable Care Organization 3. CMMI Come Home Pilot 4. United Healthcare Episode of Care 5. Aetna Oncology Patient Centered Medical Home 6. Other

1. CAP 2. Episode/Bundled Payment 3. Case Management Fees 4. Shared Savings 5. Gain Sharing 6. Other If you answered yes about participating in a payer initiative, what model in particular are you engaging in? (Choose all that apply)

Payment Reform Starts with Practice Transformation Requires a complete mind set change Strong physician leadership Education Buy-in by all members of care team Pathways/Guidelines Patient triage Case management Patient navigation

1. Community-based practice/clinic 2. Hospital-based practice/clinic Are you a community-based practice/clinic or a hospital-based practice/clinic? (Choose one)

Key to successful payer and provider payment reform initiatives: Contractual Operational

1. Oncology Medical Home 2. Accountable Care Organization 3. Bundled Episode of Care 4. Case Management Fees 5. Other If not currently participating in a payer pilot or CMMI initiative, is your practice/clinic intent on pursuing one of the following? (Check all that apply)

Contractual Statement of work Shared savings Quality measures – need to be easy to identify and report Data sharing Try to avoid deals that are resource-intensive or too- burdensome (Standardize)

Operational Automate as much as possible Identify dedicated staff and resources Centralize the intake process Implement a medical home infrastructure: Navigation Triage Case management Other support services Timely identification of eligible patients Real time data from payer Monthly or quarterly reconciliations and audits Regular joint operation committee meetings Education! Education! Education!

Tammy Chambers Director of Contracting The Center for Cancer and Blood Disorder Thank you