In a word — a lot. Sorry for the length of this Thoughts from COA post but we have been doing so much, and running so fast, that the posts have been taking a back seat to the doing. So, we will provide a brief-as-possible but thorough update on what COA is doing on several different fronts starting with the Oncology Medical Home and payment reform. Then, we’ll touch on some key legislative efforts. Finally, we’ll review the Hill day and the upcoming Community Cancer Care Advocacy Forum and the 2013 COA Community Oncology Conference. Here goes…
Oncology Medical Home and Payment Reform
The Board of Directors of COA has empowered the establishment of a Steering Committee to direct the overall efforts of the COA Oncology Medical Home initiative. The committee is comprised of oncologists (4), private payers (5), practice administrators (2), a PharmD, a patient, industry (ION), and cancer community group representation (ASCO, NCCN, NPAF). The committee is chaired by Bruce Gould, MD, a practicing community oncologist with Northwest Georgia Oncology Centers. To date, the committee has helped define the model of the Oncology Medical Home, starting with identifying the needs of patients, providers, and payers in the delivery of cancer care. This effort then allowed the committee to identify and endorse an initial set of 16 quality and value measures of cancer care. Additionally, the committee backed the development of a patient satisfaction tool, which is modification of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey tool.
An Implementation Team was also formed to identify the information, tools, software, etc. required to turn oncology centers into fully functioning Oncology Medical Homes. This team is chaired by Carol Murtaugh, RN, a practice administrator with Hematology & Oncology Consultants (Nebraska & Iowa). To date, the team compromised of oncology practice administrators has identified the resources (over 50 and counting) and is working to pull those together into an oncology medical home “tool kit.” The goal is to provide practices — according to an oncology medical home assessment — a customized set of tools to move along a path of increasing sophistication.
In the near future COA will be launching a website totally dedicated to the Oncology Medical Home. Our goal is to help practices become fully functioning Oncology Medical Homes and to attach this to appropriate payment models.
The Oncology Medical Home is a major focus for COA and consumed much of the discussion at the recent meeting of the COA Board in Washington, DC. As part of this initiative, Mark Thompson, MD, a practicing oncologist with the Zangmeister Cancer Center in Ohio, is chairing a COA Payment Reform Task Force examining possible new payment models for both Medicare and private insurance. The task force has been looking at real practice data and discussing alternative models that would be potentially feasible economically and from an implementation standpoint. COA will provide more information as available.
Legislative Agenda in DC
As you know, Congress is in recess until after the elections. When they return to Capitol Hill, members will have to tackle two cuts looming for Medicare. The first is the patch to the SGR that runs out by the end of the year. If Congress does not address this, all physicians will face a payment cut for Medicare services of over 27%. Additionally, the failure of the debt “super committee” to find at least $1.2 trillion in deficit reduction kicks in the “sequestration” process whereby Medicare will be cut 2% across the board. This cut is focused on provider reimbursement and notably in the case of oncology would reduce ASP + 6% reimbursement for drugs to a little over ASP + 4%. We have been focusing on explaining the impact of the Medicare cuts to date on oncology — clinic closings, higher costs, drug shortages — and describing how the SGR and sequestration cuts would be devastating to cancer care. This was a focus of the recent Hill day as well (see below).
In addition to gearing up to fight any further Medicare payment cuts, COA has been very involved in advocating for the prompt pay solution to actually increase Medicare drug reimbursement. COA worked with other organizations concerned about getting the prompt pay problem fixed. Among other activities, letters were sent to the House and Senate chairs and ranking members of the committees overseeing Medicare legislation. COA is putting a big push onto getting the prompt pay solution included in any Medicare legislation moving during the lame duck session of Congress after the elections.
COA has been very involved in working with House and Senate offices interested in fixing the root cause of drug shortages — flawed Medicare drug reimbursement. We believe that the House will introduce legislation right after the elections led by Congressman Bill Cassidy, MD (R-LA), who addressed the COA Hill day participants (see below).
Bloomberg Government released a report tying Medicare reimbursement to the drug shortages. Click here to access that report.
Community Cancer Care Day on Capitol Hill
We held a very successful day on Capitol Hill on September 20 led by Dr. Michael Diaz from Florida Cancer Specialists and the FLASCO team headed by Dorothy Green. This day actually produced immediate results as there were a lot of staff emails flowing for follow-up information on the topics discussed. These included the SGR and sequestration cuts, the prompt pay problem and solution, drug shortages, and some miscellaneous topics important to community oncology.
One of the highlights of the Hill day actually took place the night before when we gathered to discuss the day on Capitol Hill. Congressman Cassidy stopped by to talk about the importance of fixing the SGR and drug shortages problems. He successfully motivated everyone to talk from the heart about cancer care while on Capitol Hill.
COA is looking at the possibility of conducting a “virtual” Hill day right after the elections. Stay tuned.
Community Cancer Care Advocacy Day Forum
On October 24, 2012, COA and Vital Options will be conducting an Advocacy Forum in Washington, DC focused on the “care” as opposed to the “cure.” Importantly, there is a lot of advocacy focused on the “cure” but a lot less on the “care” of cancer. The objective of this forum is to discuss issues dealing with the care to other cancer advocacy organizations, members of the cancer community, and congressional staff. This day will actually be the start of a series of events focused on the “care.” We will never find a “cure” for cancer if we don’t pay attention to the “care.”
Contact Rose Gerber at roseg@COAcancer.org with any questions about the forum.
2013 Community Oncology Conference
We’re going to Disney World!
We are excited to announce that COA is holding its own conference for community oncology practices next year on March 22-23, 2013 in Disney World. What better place — the hotbed for innovation and imagination — to unite and move community oncology forward in this new, uncertain era of health care reform. You’ll hear from innovators talking about practical solutions to re-engineering your operations, building an oncology medical home, and transforming your practice business model to optimize success, among other topics. Additionally, we will have a unique clinical track for providers, designed by community oncologists. And we will once again sponsor a concurrent session focused on patient advocacy.
The conference co-chairs are Patrick Cobb, MD (Montana), Bruce Gould, MD (Georgia), Marissa Medalla Rivera (California), Scott Tetreault, MD (Florida), and Jeffrey Vacirca, MD (New York). The co-chairs are hard at work developing the conference schedule and agenda for a great conference. So, save the date of March 22-23, 2013.
The entire cancer care delivery team of oncologists, allied practitioners, and administrators should attend this unique, practical conference. More details to follow.
Contact Mary Kruczynski at maryk@COAcancer.org with any questions about the conference, including exhibiting at it.
There is actually a lot more going on at COA but we will stop here. Look for more updates on this website.