Bo Gamble, COA, Dir. of Strategic Practice Initiatives Laura Stevens, IOBS, Program Director Daniel...

ONCOLOGY MEDICAL HOME ACCREDITATION

FRIDAY MARCH 26, 2015

Bo Gamble, COA, Dir. of Strategic Practice InitiativesLaura Stevens, IOBS, Program DirectorDaniel McKellar, MD, FACS, Chair, Commission on Cancer


History of this Program

3Oncology Medical Home

History

Why the need

• Payers (Medicare and private insurers) are demanding quality, cost control, accountability, and predictability

– All are trying to quantify quality and value

– Payers are teaching and learning from each other

• The cost of treating cancer is increasing

– Payment of cancer care is at a crossroads

– Every payer with a pathway is unsustainable and not good medicine

• The landscape of all of cancer care is changing due to unstable and unsustainable reimbursement

– Leaving treatment gaps, especially in rural areas

– Increasing costs


History

Why Accreditation

Important for validation of compliance of standards.

Assures appropriate structures and processes in place.

Provides accountability. Promotes best practices. Improves patient and other stakeholder

confidence in the quality of care. Identifies areas needing improvement. Decreases variations in care. Improves efficiency of care.


History

COA

Directed by the COA Board of Directors Collaborative industry wide focus on the OMH Resources

• Website• Roadmap• Checklists• Policy and Procedure Templates• Patient Education Materials• Patient Satisfaction Survey/Benchmarking


History

COME Home• Robust use of health IT systems (EMR, PMS, lab systems, etc.)

• Ongoing relationships with a personal oncologist to provide first contact and continuous, comprehensive care

• Physician-led team-based care, where every member of the team works at the top of their license

• Patient and Family orientation, with Patient Education on how a patient can best benefit from the new system

• Integrated and coordinated care with automated real-time decision support system to provide aggressive symptom management

• Evidence-based medicine and performance measures to assure quality and safety and generate true outcomes data

• Enhanced access, such as late hours and same-day appointments

• Enhanced payment through Medicare CMMI


History

How can we improve upon other models

OMH Accreditation program focuses on alignment with community oncology practice’s priorities

Domains and Standards are Oncology specific vs. the existing PCMH (Primary Care Medical Home)

Program focused on:

• Quality

• Value

• Outcomes


Commission On Cancer


History

Commission On Cancer

• 80 years of experience accrediting cancer programs:

• Comprehensive Patient-Centered standards.

• Leader in quality metric development and implementation.

• Significant infrastructure in place:

• Well-trained, knowledgeable staff.

• Trained and experienced surveyor team.

• Experience with data on cancer patients (NCDB).

• Numerous educational programs for cancer programs.

• National recognition for accrediting cancer programs.


Our Mission and Who We Are

“The Commission on Cancer is a consortium of professional organizations dedicated to

improving survival and quality of life for cancer patients through standard-setting, prevention,

research, education, and the monitoring of comprehensive quality care.”

55 professional member organizations focusing on

Clinical issuesAdvocacyResearchAdministrative services


Progress To Date Standards workgroup meetings for last 12

months. Standards finalized. Draft of standards manual completed. Pilot practices educated on standards. Onsite OMH accreditation visits completed:

• Accreditation questionnaire • Policies • Procedures• 19 OMH Measures • Discussions on workflow• Chart review


CoC OMH Accreditation Pilots

Practice ST Date(s)Oncology Hematology Care, Cincinnati OH February 24th Center for Cancer and Blood Disorders, Fort Worth TX February 24th Dayton Physicians Network OH February 25th Austin Cancer Center TX February 25th Oncology Hematology Associates of Springfield M.D. P.C.

MO March 3rd

Northwest Georgia Oncology Center GA March 5th Space Coast Cancer Center FL March 20th Hematology Oncology Associates of Central New York

NY March 31st

New Mexico Oncology Hematology Center NM April 14th Maine Center for Cancer Medicine ME April 15th


Reminder….

Pilot


Eligibility Criteria • Essential components of an Oncology Medical Home

Domains • #1 Patient Engagement • #2 Expanded Access• #3 Evidence Based Medicine• #4 Comprehensive Team Based Care• #5 Quality Improvement

Components:

Draft


Eligibility• The entire cancer care team supports and promotes

the OMH• Certified EHR• Submits date that demonstrates compliance

Domains • #1 Patient Engagement

– Patients educated on OMH– Financial counselors assist patients – Practice has a patient portal– Patients have access to their medical information

Components:

Draft


Draft

Domains • #2 Expanded Access

– A new patient can easily access their OMH – An established patient can easily access their OMH

• #3 Evidenced Based Guidelines – Treatments are according to guidelines – Clinical trials are offered through the practice

Components:


Domains • #4 Comprehensive Team Based Care

– The medical oncologist directs the team – The practice coordinates with other provider teams– Coordinates with other CoC programs– Psychosocial assessment and interventions – Patients receives treatment, survivorship and end of life care

plans

• #5 Quality Improvement – Practice assures completeness of clinical data – Participates in standard patient satisfaction surveys– Quality improvement processes

Components:

Draft


Emphasis on….

Value


Must be….

Meaningf

ul


Assistance IT Vendors

• Altos• Elekta• FlatIron• IKnowMed• NantHealth• Unlimited Systems

Legislation – SGR Repeal, H.R 1416 Grants – CMMI Pilot programs w/private payers

• Aetna• United • BCBS• Humana


Next Steps – Lesson Learned

What cancer care team has learned from the accreditation effort.

Suggestions from the pilots on how to improve the accreditation effort

Advice from the pilots for other cancer care teams.


Next Steps – Commission on Cancer

Finalize standards Optimize survey process Develop a business plan to ensure this is self-

sustaining Determine mechanism(s) to obtain data for

quality measures Determine interest from other practices Engage payers-How can we make this

meaningful to them? Expand to as many as 50 more practices in 2016

[email protected]

mailto:[email protected]


Questions/Comments

ONCOLOGY MEDICAL HOME

An initiative for all stakeholders

Bo Gamble, COA, Dir. of Strategic Practice Initiatives Laura Stevens, IOBS, Program Director Daniel...

Documents

Transcript of Bo Gamble, COA, Dir. of Strategic Practice Initiatives Laura Stevens, IOBS, Program Director Daniel...