1. Community Oncology Conference Thursday April 23 rd, 2015

2. 2 Oncology Medical Home Harder Than It Sounds

3. 3 Oncology Medical Home Intent of OMH  Develop a new approach to health care: Starting with cancer care With emphasis on: – Developing the right strategies – To do the right things – Proving that you did the right things – Getting recognized – Getting rewarded  Be ahead of industry changes that are inevitable

4. 4 Oncology Medical Home #1 – Think Differently

5. 5 Oncology Medical Home #1 – Think Differently  The OMH is good for patients and for healthcare  Everything you do matters  Everything you do makes a positive impact  However…. Every action causes a reaction Are your results positive? What about quality? What about value? Are you getting better? How do you know you are getting better?

6. 6 Oncology Medical Home #2 – Design it

7. 7 Oncology Medical Home #2 – Design it  Your goal should be efficient, comprehensive, timely and effective in proving that your team IS the best cancer team on the planet.  Not just printed policy or procedure, but workflow change  Educate the care team, change the mindset  Be creative  Remove prior boundaries and pre-conceived notions

8. 8 Oncology Medical Home #3 – Do the Right Thing  No argument – you do good things  Can you do better?  Is your “good” aligned with the needs of Patients, Families, Payers, Employers?  How do you know?  How do they know?

9. 9 Oncology Medical Home Quality, Value, Outcomes Measures Patient Care Measures % of cancer patients that received a treatment plan prior to the administration of chemotherapy. % of cancer patients with documented clinical or pathologic staging prior to initiation of first course of treatment. % of chemotherapy treatments that have adhered to NCCN guidelines or pathways. Antiemetic drugs given appropriately with highly emetogenic chemotherapy treatments. % of cancer patients undergoing treatment with a chemotherapy regimen with a 20% or more risk of developing neutropenia and also received GCSF/white cell growth factor. NEW 08/07/13 - Appropriate use of advanced imaging for early stage breast cancer patients. NEW 08/07/13 - Appropriate use of advanced imaging for early stage prostate cancer patients. NEW 08/07/13 - Presence of patient performance status prior to treatment. Resource Utilization # of emergency room visits per chemotherapy patient per year. # of hospital admissions per chemotherapy patient per year. Survivorship % of cancer patients that received a survivorship plan within X days after the completion of chemotherapy. % of chemotherapy patients that received psycho/social screening and received measurable interventions as a result of the psycho/social screening.

10. 10 Oncology Medical Home Survivorship Survival rates of stage I through IV breast cancer patients. Survival rates of stage I through IV colorectal cancer patients. Survival rates of stage I through IV NSC lung cancer patients. End of Life % of patients that have Stage IV disease that have end-of-life care discussions documented. Average # of days under hospice care (home or inpatient) at time of death. % of patient deaths where the patient died in an acute care setting. A measurement of chemotherapy given near end of life. Other Patient satisfaction reporting and scoring.

11. 11 Oncology Medical Home Example: Patient Phone Triage Active chemotherapy patient needs an appointment.

12. 12 Oncology Medical Home This is Mary at Community Cancer Center. May I help you ? Yes ma’am, this is …

13. 13 Oncology Medical Home #4 – Prove you are doing the right things  OMH is not Meaningful (Meaningless) Use  Some measures are numbers/reports only  Some measures are process driven  Change your process MEASURE and REPEAT!

14. 14 Oncology Medical Home

15. 15 Oncology Medical Home #4 – Prove what you are doing CategoryNationalStatePractice Size%Medicare Overall91.19%92.95%90.98%91.78% Timeliness84.22%87.61%83.73%85.37% Thoroughness91.32%92.89%91.41%91.69% Communications98.89%99.07%98.74%99.00% Friendliness- Helpful 96.96%97.99%96.47%97.53%

16. 16 Oncology Medical Home

17. 17 Oncology Medical Home #5 – Share what you are doing

18. 18 Oncology Medical Home #5 – Share what you are doing  Practice Team/Teams  New Patients  Families of New Patients  National Payers  Local Payers  Local Employers  Other Practices for “Best Practices”

19. 19 Oncology Medical Home #6 – Make progress  Visits, revenue, volume – NO PROBLEM  What about? Quality Value Satisfaction OMH 19 Measures Financial assistance Pathway compliance Etc.

20. 20 Oncology Medical Home #6 – Make progress

21. 21 Oncology Medical Home #6 – Make progress CategoryNationalStatePractice Size%Medicare Date Range1st2nd1st2nd1st2nd1st2nd Overall91.42%92.51%92.97%93.10%92.16%92.27%91.54%92.86% Timeliness84.88%86.81%88.39%87.41%86.17%85.91%85.16%87.27% Thoroughness91.35%92.08%92.91%92.96%92.13%92.29%91.50%92.32% Communications98.97%99.10%99.00%99.22%98.90%99.11%98.97%99.16% Friendliness- Helpful 97.29%98.00%97.81%98.32%97.37%97.85%97.33%98.24% 1st2nd In the last 12 months, when you phoned this provider’s office after regular office hours, how often did you get an answer to your medical question as soon as you needed? Never5.90%3.90% Sometimes6.50% Usually17.40%16.30% Always70.10%73.30%

22. 22 Oncology Medical Home #7 – Teach others  State societies  Trade journals  COA  CoC  ASCO  ACCC  ONS

23. 23 Oncology Medical Home #7 – Teach others

24. 24 Oncology Medical Home 7 Steps to Becoming an OMH 1. Think differently 2. Design it 3. Do the right thing 4. Prove you are doing the right things 5. Share what you are doing 6. Make progress 7. Instruct others

25. 25 Oncology Medical Home Questions/Comments