COA: Community Oncology Alliance

When MedPAC released several proposals to control Part B reimbursement costs, the ideas within them were not a surprise, explained Leah Ralph, director of health policy at the Association of Community Cancer Centers (ACCC). However, the ACCC has some concerns about how these proposals could impact cancer patients’ access to care.

Although Daniel George, MD, of the Duke Cancer Institute, sees value in cancer vaccines and expects they will start showing more benefit to patients, he acknowledges that a barrier to widespread use of cancer vaccines is that they don't show an immediate response.

Negotiations among House Republicans have led to a compromise that would amend the American Health Care Act and the Association of Community Cancer Centers (ACCC) is concerned the amendment would undermine patient protections that are important for people with cancer, said Leah Ralph, director of health Policy at ACCC.

When the COA Patient Advocacy Network converged on Capitol Hill on April 26, 50 advocates were able to discuss their concerns with a number of issues facing patients with cancer, including 340B and clinic consolidation, explained Rose Gerber, director of patient advocacy for the Community Oncology Alliance (COA).

When transitioning towards value-based oncology, large employers should look to value-based models that have worked for other conditions, said Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition. These successful payment models include patient-centered medical homes, bundled payments, and accountable care organizations.

Many oncology practices are still trying to understand the new Oncology Care Model (OCM) structure and focus on data reporting as they simultaneously prepare to adapt to the Merit-based Incentive Payment System (MIPS), said Barry Russo, CEO of The Center for Cancer & Blood Disorders.

Employers face tough decisions about rising costs, high-quality care, coordination of benefits, and workplace accommodations when employees are diagnosed with cancer, but they will always want to support those employees as best they can, according to Marianne Fazen, PhD, president and CEO of the Texas Business Group on Health.

Adopting the Oncology Care Model (OCM) is a challenging task for oncology practices that have to redesign their practices, but the shift from volume-based to value-based care is the way of the future, said Kashyap Patel, MD, of the Carolina Blood & Cancer Center.

Patients and providers often have very different views of goals and values when it comes to treatment, so healthcare could benefit from figuring out how to systematize the shared decision making experience, Alan Balch, PhD, chief executive officer of the National Patient Advocate Foundation, said at the Community Oncology Alliance's 2016 Community Oncology Conference.

There are a number of models that look at innovating payments and focus on care delivery changes in oncology that are a positive step forward for patients, Debra Patt, MD, MPH, MBA, director of public policy at Texas Oncology, said at the Community Oncology Alliance's 2016 Community Oncology Conference.

Many value assessment frameworks are still in their infancy and while the American Society of Clinical Oncology (ASCO)'s framework is still getting input and being adjusted, it has started an important conversation, Stephen Grubbs, MD, vice president for clinical affairs at ASCO, said at the Community Oncology Alliance's 2016 Community Oncology Conference.

Although there have been a number of new value calculators created recently, UnitedHealthcare does not plan to use any just now. Instead, it will continue covering regimens recommended by the National Comprehensive Cancer Network and in a few years the company will use data from its prior authorization tool to analyze performance of regimens, explained Lee Newcomer, MD, MHA, senior vice president, Oncology, Genetics and Women's Health, UnitedHealthcare.

The Community Oncology Alliance (COA) created its Payer Exchange Summit to get payers who are thinking about getting involved in oncology payment reform or want to know what to do exposed to successful pilots, explained Ted Okon, MBA, executive director of COA.