Community Oncology Conference Thursday April 23 rd, 2015

2 Oncology Medical Home … you have cancer… OH MY…….

3 Oncology Medical Home Who is a good doctor? What about the kids, the grandkids? Where will I go for treatment? Can I afford treatment? Who will help me at home? What do I need to know? Can I be cured? How long do I have?

4 Oncology Medical Home So… What is good cancer? How do we know? What can COA do? ….and how?

5 Oncology Medical Home

6 OMH Steering Team  COA organized a group of industry leaders to help Patients Insurance companies Physicians and their care teams Cancer care advocacy groups  Collaborate and decide on what is important  Objective criteria to distinguish high quality and value in cancer care

7 Oncology Medical Home OMH Steering Committee Needs PatientsPayersProviders Best Possible OutcomeBest Possible Clinical Outcomes Best Outcome for Patient Docs with the 3 A’s (Able, affable, accessible) Member Satisfaction / Experience Satisfied patients and family Least Out Of Pocket Expense Control Total Costs / Variability Fairest Reimbursement to Provide Quality Patient Care Education and Engagement of the Patient in the Care Plan Productivity / SurvivorshipCompensated for Cognitive Services Including Treatment Planning, End of Life Care and Survivorship. Best Quality of LifeMeaningful Proof of Quality / Value Less Administrative Burdens

8 Oncology Medical Home OMH Steering Team Objective Measures  20 specific measures Clinical appropriateness 3 specific, written and comprehensive communications – Treatment plan – Life after cancer – End of life wishes and care Resources used Patient Satisfaction  Objective criteria to measure quality and value

9 Oncology Medical Home OMH Implementation Team  Practice managers helping their colleagues in understanding, applying and measuring “good”.  Web site of resources  National standardized process to gather feedback from patients and their families regarding: Response time Thoroughness Follow-up Friendliness (And to use this feedback to improve and measure improvement.)

10 Oncology Medical Home OMH Payment Reform Team  Payment system should be based on utilization and consumption only  Reward high quality AND value  For all cancer care teams in all sites of care  Pilots of concept Medicare Aetna Insurance United Insurance Others

11 Oncology Medical Home OMH Accreditation Team  Promote a standardized and systematic approach to deliver AND measure quality, value and positive outcomes in cancer care: Policies – What are you going to do. Procedures – How are going to do it Measures – Proof that you are doing it  Commission on Cancer – certifying entity Accrediting cancer programs since 1922 Governed by over 50 cancer care advocacy organizations  10 Pilot Practices

12 Oncology Medical Home OMH Accreditation Team Similar To….but for Cancer Care

13 Oncology Medical Home OMH Information Technology Team  Efficient gathering of information needed to standardize and benchmark quality and value…so that improvement can be measured.  All IT partners to help identify and report information  Used by: Cancer care teams to measure and improve Insurance companies to model reimbursement plans that encourage quality and value Patients to get “good” care

14 Oncology Medical Home Measure it

15 Oncology Medical Home

16 Oncology Medical Home Questions/Comments Thank You!!! Bo Gamble Community Oncology Alliance Director of Strategic Practice Initiatives