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Oncology Practice Administrators Discuss Early Findings From the OCM

Surabhi Dangi-Garimella, PhD
At the 2017 Community Oncology Conference, practice administrators from 2 community clinics discussed the changes they made to their practice to accommodate the reporting requirements of the Oncology Care Model (OCM), and the follow-up planned as they work to implement changes.
Constructive Lessons Learned
Rainey identified a big advantage of the patient-centered aspect of OCM.

“It forced us to communicate more with our patients and document things that were historically not documented," she said. "For example, we were not documenting advance care directives for our patients.”

The clinic identified this as an area that needed improvement and now 75% of their Medicare patients have these directives documented. “It can be uncomfortable for our staff as well as patients, but we are proud that we have championed this,” she said.

Both Rahman and Rainey reiterated that communication across the various departments in their respective organizations was key to identifying problem areas and working to implement changes.
Baird was curious to find out the patient feedback when informed that the clinic would be participating in a new type of reimbursement model.

“We opted to mail a letter to Medicare and on-chemotherapy patients,” Rainey told the audience. While they had a lot of questions initially, they were also happy to see more information on their care plan and medications, she said.

Rahman’s practice devised a strategy to make the information more patient friendly. “The letter can be dense, and so we created a cartoon to help patients understand their plan better. We needed to supplement the letter and explain it better,” he said.

OCM Feedback
The first wave of OCM feedback reports, for practices that had 6-month chemotherapy episodes, are out. Rainey said that while the reports were a little overwhelming, initially, they soon noticed trends as they dug deeper. “We noticed that E&M [evaluation and management] visits were high for our practice and when we looked closer, it helped us locate an outlier physician.” She also explained how they placed triage pathways in place to reduce the number of hospital and emergency room (ER) visits for patients who were troubled with nausea, vomiting, and diarrhea.

“We need to get a deeper dive into this, with the help of data analytics companies, to avoid a knee-jerk reaction so we can plan this out better,” Rainey added.

Rahman’s practice also focused on ER utilization and they were able to point out the exact dollars associated with patient visits to various hospitals across Houston and the variation seen for the same treatment. “But we have to partner with analytics companies and we’d need this data more frequently,” he said.

Rahman emphasized that while their practice has extended hours, raising patient awareness to call or come to the clinic instead of visiting a hospital or the ER is vital.

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