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Evidence-Based Oncology December 2015
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COA Payer Summit
Surabhi Dangi-Garimella, PhD
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COA Payer Summit

Surabhi Dangi-Garimella, PhD
Providers and payers came together to discuss challenges and share success stories as they adapt to the changing healthcare realm.
“COME HOME also positioned us for the Oncology Care Model (OCM),” the initiative proposed by CMS.3 “The infrastructure costs, though, are real to run this project. To transform the clinic into an OCM was huge, but COA and Barbara provided us with tremendous support,” D’Amato indicated.

McAneny said, “When we started COME HOME, we were only thinking of patients and doctors. Most of my patient population is poor. So the point was to keep them out of the ED and from being admitted to a hospital. The triage pathways that we created solidified what we were doing. We had to educate our patients and ask them to call us first rather than 911. This took a lot of educating our practice staff on how to handle these patients and them to teach patients to call us rather than ED.” She explained that the complexities of the healthcare system should be the least of a sick patient’s worries, so “we took care of navigating the healthcare conundrum for the patients.”

She acknowledged that working with COA and the Commission on Cancer for the accreditation worked very well for the project. “We have seen significant impact on total cost of care and reduced the number of days of hospitalization.” At the end of the day, McAneny wants to see a restructuring of payments “so physicians have the flexibility to do what they want to do while keeping patients happy with the quality of care they get.” EBO

References

1. Hoverman JR, Klein I, Harrison DW, et al. Opening the black box: the impact of an oncology management program consisting of level I pathways and an outbound nurse call system. J Oncol Pract. 2014;10(1):63-67.

2. Newcomer LN, Gould B, Page RD, Donelan SA, Perkins M. Changing physician incentives for affordable, quality cancer care: results of an episode payment model. J Oncol Pract. 2014;10(5):322-326.

3. Oncology Care Model. CMS website. https://innovation.cms.gov/initiatives/Oncology-Care/. Updated November 13, 2015. Accessed November 17, 2015.

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