Transcript Issues in Oncology: A Payer

Provider Collaborations
in Oncology
Finding Common Ground
ON76175 02/2012 © 2012, Lilly USA, LLC.
This program is sponsored by and the speaker is presenting on behalf of Lilly USA,
LLC. It is being presented consistent with FDA guidelines and is not approved for
continuing education credit.
Jim M. Koeller, MS
 Professor and Eli Lilly/C.R. Sublett Endowed Fellow in Pharmacy
 Adjoint Professor of Medicine and Oncology
 Member of the Center for Pharmacoeconomic Studies
 Recipient of numerous awards, including an American Cancer Society
National Merit award and an invitee of the American Society of Clinical
Oncology Cancer Experts
 Serves on the editorial board of the journal Pharmacotherapy while serving
as a reviewer for several other oncology- and pharmacy-related journals
 Research focuses on healthcare economics, pharmacoeconomics, and
outcomes research primarily in cancer, but also in other disease areas
2
Meeting Considerations
 During this meeting, we encourage you to
– Speak candidly
– Ask questions
– Share ideas
 Our goal is to gain a better understanding of the most pressing issues
in cancer care
 Discussions regarding specific cancer agents or claims related to
specific products or classes of medications should be avoided
 Off-label product discussions are prohibited at all times
3
Presentation Overview
 Oncology Care in a Changing Healthcare Environment
 Current Oncology Practice and Reimbursement Landscape
 Establishing Value in Cancer Care
4
The Current Oncology Landscape
Payers
• Controlling rapidly
escalating cancer
treatment costs1,2
• Managing off-label
prescription use3
• Supporting costeffective quality
cancer care1,2
Providers1,4
• Utilizing new agents
and therapies
• Incorporating
evolving standards
of care into practice
• Efficiently operating
an oncology practice
Patients1,5
• Accessing
appropriate care
in a timely manner
• Receiving highquality cancer care
1. Goldsmith M. Presented at: The Center for Business Intelligence 3rd Annual Effective Oncology Benefit Management Conference;
October 6, 2008; Chicago, IL.
2. Kuzner W. Association for Value-Based Cancer Care Web site. http://www.valuebasedcancer.com/article/payer-trends-oncologychallenges-and-solutions. Accessed January 20, 2012.
3. Reinke T. Manag Care. 2011;20(9):14-16. http://www.managedcaremag.com/archives/1109/1109.medmgmt.html.
Accessed January 29, 2012.
4. Fuerst M. Oncol Times. 2010;32(16):20-22.
5. Healthreform.GOV Web site. http://www.healthreform.gov/reports/breastcancer/breastcancer3.pdf. Accessed January 23, 2012.
5
Oncology Care in a Changing
Healthcare Environment
Oncology Care in a Changing Healthcare Environment
 Healthcare reform1-3
– The Affordable Care Act (ACA) contains a number of provisions that impact oncology
practices
• Patient-centered medical homes (PCMHs)
• Hospital value-based purchasing (VBP)
• Accountable care organizations (ACOs)
 Pathways4
– Combine evidence-based practices and clinical community consensus to develop consistent
treatment approaches
 Comprehensive medical home5,6
– Horizontal patient management system
– Includes evidence-based medicine, pathways,7 nursing care, and end-of-life care
1. Healthcare.gov Web site. http://www.healthcare.gov/law/timeline/full.html. Accessed January 4, 2012.
2. Healthcare.gov Web site. http://www.healthcare.gov/prevention/nphpphc/advisorygrp/cmmi-prevention-health-promotion-10032011.pdf.
Accessed January 4, 2012.
3. AHRQ Web site. http://pcmh.ahrq.gov/portal/server.pt/community/pcmh__home/1483/what_is_pcmh_. Accessed February 13, 2012.
4. Butcher L. Oncol Times. 2010;32(12):11-13. http://journals.lww.com/oncology-times/Fulltext/2010/06250/Cancer_Care_Pathways_
Catching_on_with_Payers.1.aspx. Accessed January 4, 2012.
5. Nutting PA, et al. Health Aff (Millwood). 2011;30(3):439-445.
6. Eagle D, Sprandio J. Oncology (Williston Park). 2011;25(7). Cancer Network Web site. http://www.cancernetwork.com/practice/content/
article/10165/1875328. Accessed January 12, 2012.
7. Neubauer MA, et al. J Oncol Pract. 2010;6(1):12-18.
7
Healthcare Reform
 The Affordable Care Act (ACA) of 2010 contains a number of provisions that
will affect healthcare, including the practice of oncology1-3
 Examples of ACA provisions include
– Accountable care organizations (ACOs)1
– Patient-centered medical homes (PCMHs)2,3
– Hospital value-based purchasing (VBP)1
 By 2014, state exchanges formed as a result of the ACA will begin offering
medical insurance,1 which will cover many Americans who previously may
not have been covered
1. Healthcare.gov Web site. http://www.healthcare.gov/law/timeline/full.html. Accessed January 4, 2012.
2. Healthcare.gov Web site. http://www.healthcare.gov/prevention/nphpphc/advisorygrp/cmmi-prevention-health-promotion-10032011.pdf.
Accessed January 4, 2012.
3. AHRQ Web site. http://pcmh.ahrq.gov/portal/server.pt/community/pcmh__home/1483/what_is_pcmh_. Accessed February 13, 2012.
8
Pathways
 Pathways combine evidence-based practices and clinical community




consensus to develop consistent treatment approaches1
Pathways from many sources are being integrated into the practice of
oncology1
Two studies of pathways showed cost advantages of on-pathway versus offpathway treatment, with outcomes consistent with the published literature2,3
Pathways may enable oncologists and oncology practices to better position
themselves to participate with ACOs, PCMHs, and other stakeholders4
The impact of ACOs, PCMHs, and hospital VBP will likely be felt first in
Medicare reimbursement, followed by private payers
1. Butcher L. Oncol Times. 2010;32(12):11-13. http://journals.lww.com/oncology-times/Fulltext/2010/06250/Cancer_Care_Pathways_
Catching_on_with_Payers.1.aspx. Accessed January 4, 2012.
2. Neubauer MA, et al. J Oncol Pract. 2010;6(1):12-18.
3. Hoverman JR, et al. J Oncol Pract. 2011;7(suppl 3):52s-59s.
4. D3 Oncology Solutions Web site. http://www.d3onc.com/pathways. Accessed January 4, 2012.
9
Comprehensive Medical Home
 The Oncology Patient-Centered Medical Home™* (OPCMH) model provides
a partial solution to fragmented delivery of care1,2
 Key features of OPCMH include1,3
– Open access, enhanced care coordination, comprehensive care,
and sustained personal relationships
 An oncology practice becomes the central coordinator of care throughout
all phases of a patient’s treatment after a cancer diagnosis1
– Surgery, radiation, chemotherapy, and survivorship
 OPCMH represents a logical platform to build a value-oriented, outcome-based
system of delivering care by addressing important challenges1
– Cost control, quality assurance, outcome measures, and process improvement
*Oncology Patient-Centered Medical Home™ is a trademark of the National Committee for Quality Assurance.
1. Eagle D, Sprandio J. Oncology (Williston Park). 2011;25(7). Cancer Network Web site.
http://www.cancernetwork.com/practice/content/article/10165/1875328. Accessed January 12, 2012.
2. Sprandio JD. Commun Oncol. 2010;7:565-572.
3. Nutting PA, et al. Health Aff (Millwood). 2011;30(3):439-445.
10
Survivorship and Chronic Care
 Survivorship and chronic care are part of the national healthcare continuum-
of-care priority1,2
 The number of cancer survivors has more than tripled—to almost 10
million—over the past 30 years, and survival rates are increasing3
 Guidelines for survivorship and chronic care are included in accreditation
standards established by the Commission on Cancer, representing 30% of all
hospitals and more than 70% of newly diagnosed cancer patients annually2
 Primary care physicians seldom receive explicit guidance from oncologists4
1. NQF Web site. http://www.qualityforum.org/projects/care_coordination.aspx. Accessed January 4, 2012.
2. Commission on Cancer Web site. http://www.facs.org/cancer/coc/cocprogramstandards2012.pdf. Accessed January 4, 2012.
3. IOM Web site. http://www.iom.edu/~/media/Files/Report%20Files/2005/From-Cancer-Patient-to-Cancer-Survivor-Lost-in-Transition/
factsheetfactsandfigures.pdf. Accessed January 9, 2012.
4. IOM Web site. http://iom.edu/Reports/2005/From-Cancer-Patient-to-Cancer-Survivor-Lost-in-Transition.aspx. Accessed January 4, 2012.
11
End-of-Life Care
 Organizations such as the National Quality Forum (NQF) and NCCN
have developed preferred practices and performance measures for
palliative and end-of-life care1,2
– Includes the coordination of multiple specialists
 More than 1 million people die each year without access to palliative
and end-of-life services3
 Medicare paid for over 83% of all hospice care in 20094
– The median time in hospice is 17 days5
1. NQF Web site. http://www.qualityforum.org/Projects/n-r/Palliative_and_Hospice_Care_Framework/Palliative___Hospice_Care__
Framework_and_Practices.aspx. Accessed January 4, 2012.
2. NCCN Web site. http://www.nccn.org/professionals/physician_gls/pdf/palliative.pdf. Accessed January 4, 2012.
3. NQF Web site. http://www.qualityforum.org/Topics/Palliative_and_End-of-Life_Care.aspx. Accessed January 4, 2012.
4. Senior Journal.com Web site. http://www.seniorjournal.com/NEWS/Eldercare/2010/20101011-HospiceCareIncreasingBut.htm.
Published October 11, 2010. Accessed January 4, 2012.
5. Rau J. New York Times. June 28, 2011:D1.
12
Current Oncology Practice and
Reimbursement Landscape
Current Oncology Practice and Reimbursement Landscape
 Changing sites of care1
– Shifting of patients from private clinics to hospital/health system care
 Alternate reimbursement models2,3
– Pay for performance, episodes/segments of care
 Oral oncolytics4,5
– Maintaining continuity of care with the use of outpatient oral agents6
 Risk evaluation and mitigation strategies (REMS)7
– Potential risks of complex REMS with regard to patient care
 Biosimilars8
– Approval of biosimilars may reduce cost and increase accessibility
1. COA Web site. http://www.communityoncology.org/UserFiles/files/87f3205e-ee73-4b03-85fb-094870cc430d/COA%20Community%20
Oncology%20Practice%20Impact%20Report%203-31-11(1).pdf. Accessed January 4, 2012.
2. ANCO Webinar. http://www.anco-online.org/P3InnoventANCOWebinar.pdf. Accessed February 13, 2012.
3. Burns J. Manag Care. 2011;20(1):12-14, 16. http://www.managedcaremag.com/archives/1101/1101.cancerdrugs.html. Accessed January 4, 2012.
4. CuraScript. http://www.curascript.com/bin_web/documents/08DrugTrendReportCuraScript.pdf. Accessed January 10, 2012.
5. EMD Serono. Rockland, MA: EMD Serono; 2011.
6. Partridge AH, et al. J Natl Cancer Inst. 2002;94(9):652-661.
7. DeMartino J. OncLive Web site. http://www.onclive.com/publications/obtn/2011/January-2011/impact-of-risk-evaluation-and-mitigationstrategies-in-oncology. Accessed January 29, 2012.
8. Kozlowski S, et al. N Engl J Med. 2011;365(5):385-388.
14
Changing Sites of Care
 Due mainly to cuts in chemotherapy reimbursement, the Community
Oncology Alliance (COA) reports that from October 2007 to March 20111
–
–
–
–
–
241 clinics closed
442 struggling financially
48 practices sent patients elsewhere for chemotherapy
392 practices were acquired by hospitals
132 practices merged or were acquired by other corporate entities
 Between 2005 and 2008, the medical spend on specialty drugs, in general,
shifted from physicians’ offices to outpatient facilities2
– For physicians, shifting from 76% to 63% of spend
– For outpatient facilities, shifting from 13% to 22% of spend
1. COA Web site. http://www.communityoncology.org/UserFiles/files/87f3205e-ee73-4b03-85fb-094870cc430d/COA%20Community%20
Oncology%20Practice%20Impact%20Report%203-31-11(1).pdf. Accessed January 4, 2012.
2. Express Scripts. 2010 Drug Trend Report.
15
Pay-for-Performance (P4P)
 Also known as P4P or VBP, this payment model rewards physicians, hospitals,
medical groups, and other healthcare providers for meeting certain
performance measures for quality and efficiency
 P4P can be integrated into pathways programs
 P4P seeks to generate cost-efficiencies through
–
–
–
–
–
Evidence-based, high-quality care
Health information technology
Outcomes measurement
Clinical/financial analytics
Patient support
Abbreviation: VBP, value-based purchasing. Also called VBR, value-based reimbursement.
ANCO Webinar. http://www.anco-online.org/P3InnoventANCOWebinar.pdf. Accessed February 13, 2012.
16
Episodes of Care
 This payment model reimburses for an “episode of care” by bundling
payments to groups for the full cost of care for each cancer patient
 The payer may freeze drug margins in an episodes-of-care model,
which would replace the buy-and-bill approach
 The payer may continue to pay for drug costs, office visits,
and administration fees on a fee-for-service (FFS) basis, allowing
for inflation
 In an episodes-of-care model, quality and outcomes are closely monitored
Burns J. Manag Care. 2011;20(1):12-14, 16. http://www.managedcaremag.com/archives/1101/1101.cancerdrugs.html.
Accessed January 4, 2012.
17
Oral Oncolytics
 New oral oncology agents are coming into a market historically dominated
by infused/IV medications, with many oral agents in the product
development pipeline1
 More than 90% of payers reimburse for oral oncology agents under the
pharmacy benefit as opposed to the medical benefit2
– Payers can more easily track pharmacy claims, which may give them more
control over drug utilization. Although about three-fourths of payers now track
drug spend and cost trends under the medical benefit, as well
 In general, cancer treatment places a greater financial burden on patients
than the cost of treatment for other chronic conditions3
1. CuraScript. http://www.curascript.com/bin_web/documents/08DrugTrendReportCuraScript.pdf. Accessed January 10, 2012.
2. EMD Serono. Rockland, MA: EMD Serono; 2011.
3. Bernard DS, et al. J Clin Oncol. 2011;29(20):2821-2826.
18
Risk Evaluation and Mitigation Strategies (REMS)
 In 2007, the FDA received the authority to require a REMS from manufacturers
to ensure that the benefits of a drug or biological product outweigh its risks 1
 Some oncology drugs and supportive-care medications (eg, opioids for pain
management) have associated REMS2
 Drugs with complex REMS create significantly more work for prescribers
and dispensers, which may reduce the likelihood of their use and patient access
to appropriate care2
 The results of a 2010 NCCN Trends Survey found that2
– 55% of respondents believed REMS will interfere with the provision of care
– 60% of respondents agreed REMS will drive utilization toward drugs without REMS
 REMS programs should not overburden the healthcare system, drive utilization to less
effective drugs, or increase or create healthcare disparities for cancer patients 2
Abbreviation: FDA, Food and Drug Administration; NCCN, National Comprehensive Cancer Network.
1. FDA Web site. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111350.htm.
Accessed January 4, 2012.
2. DeMartino J. OncLive Web site. http://www.onclive.com/publications/obtn/2011/January-2011/impact-of-risk-evaluation-andmitigation-strategies-in-oncology. Accessed January 29, 2012.
19
Biosimilars
 Biologics are costly because they are complex to develop and manufacture1
 Biosimilars may increase the affordability and access to biologic medications
for patients1
– Primary reason for the Biologics Price Competition and Innovation Act of 2009
(BPCI Act), which is part of the 2010 Affordable Care Act
 Biosimilars present multiple challenges, particularly in determining how similar
is similar enough when substituting complex biologics in clinical practice2
 Biosimilars must meet a higher standard of similarity to a reference product
(ie, “interchangeability”)2
– Must produce the same clinical result in any given patient with no greater safety
risks when switching from a biologic to a biosimilar
 Uncertainty exists about how biosimilars will be covered, reimbursed, and
handled in the United States1
1. Zelenetz AZ, et al. J Natl Compr Canc Netw. 2011;9(suppl 4):S1-S22.
2. Kozlowski S, et al. N Engl J Med. 2011;365(5):385-388.
20
Establishing Value
in Cancer Care
Establishing Value in Cancer Care
 Measuring outcomes and endpoints1
– Quantitative and qualitative measures
 Measures versus process
– Utilizing electronic medical records (EMRs) and pathways to improve practice
efficiencies and establish treatment patterns2,3
– Selective outcome measures1,2,4
1. FDA Web site. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm071590.pdf.
Accessed January 29, 2012.
2. Kanas G, et al. ClinicoEconomics Outcomes Res. 2010;2:1-14.
3. Lau EC, et al. Clin Epidemiol. 2011;3:259-272.
4. CMS.gov. https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp. Accessed January 29, 2012.
22
Outcome Measures or Clinical Endpoints in Oncology
 Clinical trials measure the safety and efficacy (or clinical benefit)
of interventions used against a disease
 Quantitative endpoints in clinical oncology studies include
– Overall survival (OS)
– Symptom endpoints (patient-reported outcomes)
– Surrogate endpoints are based on tumor assessment
• Disease-free survival (DFS); Progression-free survival
(PFS); Response rate (RR); Time to Treatment Failure
(TTP)
• Are these measures practical in community practice?
• Besides OS, most of these measures are probably not
practical in every-day practice
• Measurements would not be consistent or reproducible
FDA Web site. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm071590.pdf.
Accessed January 29, 2012.
23
Outcome Measures or Clinical Endpoints in Oncology
 Measures that may ‘represent’ good/bad care (also referred to
as down-stream endpoints) ~ Surrogate Markers
 Transfusions
 Return clinic visits
 ER visits
 Hospitalizations
 Infections
 Hydration
 Cancer care by inference
 To conclude from certain premises or evidence
FDA Web site. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm071590.pdf.
Accessed January 29, 2012.
24
Electronic Medical Records (EMRs)
 The use of EMRs in clinical medicine can help improve the quality of patient care,
reduce the cost of healthcare, and facilitate the transfer of patient information
among providers1,2
– Easier to analyze and typically more cost-effective than chart reviews3
 Large increases in the use of EMRs have been reported by community cancer
programs—84% in 2009 vs 65% in 20084
– 54% of them use more than 1 software program
 A 2010 survey found that EMRs were adopted by about 50% of office-based
physicians—an increase of more than 30% from 20092,5
– Unfortunately, only 10% of EMR systems were considered fully functional
 Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs
provide a financial incentive for the "meaningful use" of certified EHR technology6
– Providers must use the technology in ways that can be measured significantly
in quantity and quality
1.
2.
3.
4.
5.
6.
Kanas G, et al. ClinicoEconomics Outcomes Res. 2010;2:1-14.
Mehta NB, Partin MH. Cleve Clin J Med. 2007;74(11):826-830.
Lau EC, et al. Clin Epidemiol. 2011;3:259-272.
Eastman P. Oncol Times. 2010;32(16):19-20.
Hsiao CJ, et al. NCHS Health E-Stat. 2010.
CMS.gov. https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp. Accessed January 29, 2012.
25
Bibliography
Bibliography
Agency for Healthcare Research and Quality (AHRQ). What is the PCMH? AHRQ Web site.
http://pcmh.ahrq.gov/portal/server.pt/community/pcmh__home/1483/what_is_pcmh_. Accessed February 13, 2012.
Association of Northern California Oncologists (ANCO). Realizing pay for performance: moving from fee-for-service
to value-based reimbursement. ANCO Webinar, October 26, 2010. http://www.anco-online.org/P3InnoventANCOWebinar.pdf.
Accessed February 13, 2012.
Bernard DS, Farr SL, Fang Z. National estimates of out-of-pocket health care expenditure burdens among nonelderly
adults with cancer: 2001 to 2008. J Clin Oncol. 2011;29(20):2821-2826.
Burns J. UnitedHealthcare's bold effort to deal with cancer drug costs. Manag Care. 2011;20(1):12-14, 16.
http://www.managedcaremag.com/archives/1101/1101.cancerdrugs.html. Accessed January 4, 2012.
Butcher L. Cancer care pathways catching on with payers. Oncol Times. 2010;32(12):11-13.
http://journals.lww.com/oncology-times/Fulltext/2010/06250/Cancer_Care_Pathways_Catching_on_with_Payers.1.aspx.
Accessed January 4, 2012.
CMS.gov. CMS EHR meaningful use overview. Centers for Medicare & Medicaid Services Web site.
https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp. Accessed January 29, 2012.
Commission on Cancer. Cancer Program Standards 2012: Ensuring Patient-Centered Care. Chicago, IL: American College
of Surgeons; 2011. http://www.facs.org/cancer/coc/cocprogramstandards2012.pdf. Accessed January 4, 2012.
Community Oncology Alliance (COA). Community oncology cancer care practice impact report. COA Web site.
http://www.communityoncology.org/UserFiles/files/87f3205e-ee73-4b03-85fb-094870cc430d/COA%
20Community%20Oncology%20Practice%20Impact%20Report%203-31-11(1).pdf. Accessed January 4, 2012.
CuraScript. 2008 Specialty Drug Trend Report. http://www.curascript.com/bin_web/documents/
08DrugTrendReportCuraScript.pdf. Accessed January 10, 2012.
27
Bibliography (cont)
D3 Oncology Solutions. Via oncology pathways. D3 Oncology Solutions Web site. http://www.d3onc.com/pathways.
Accessed January 4, 2012.
DeMartino J. Impact of risk evaluation and mitigation strategies in oncology. OncLive Web site.
http://www.onclive.com/publications/obtn/2011/January-2011/impact-of-risk-evaluation-and-mitigation-strategies-inoncology. Accessed January 29, 2012.
Eagle D, Sprandio J. A care model for the future: the oncology medical home. Oncology (Williston Park). 2011;25(7).
Cancer Network Web site. http://www.cancernetwork.com/practice/content/article/10165/1875328.
Accessed January 12, 2012.
Eastman P. ACCC Survey: economic recession slows cancer centers’ equipment purchases, hiring. Oncol Times.
2010;32(16):19-20.
EMD Serono. EMD Serono Specialty Digest, 7th ed. Rockland, MA: EMD Serono; 2011.
Express Scripts. 2010 Drug Trend Report. St. Louis, MO: Express Scripts; 2011.
FDA. Guidance for industry: clinical trial endpoints for the approval of cancer drugs and biologics. FDA Web site.
http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm071590.pdf.
Accessed January 29, 2012.
FDA. Approved risk evaluation and mitigation strategies (REMS). FDA Web site.
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111350.htm.
Accessed January 4, 2012.
Fuerst M. How community oncologists are adapting to the challenges of financial survival. Oncol Times.
2010;32(16):20-22.
28
Bibliography (cont)
Goldsmith M. Navigating the oncology care maze: evidence based medicine as a pathway for payers,
providers & patients. Presented at: The Center for Business Intelligence 3rd Annual Effective Oncology Benefit
Management Conference; October 6, 2008; Chicago, IL.
Healthcare.gov. Provisions of the Affordable Care Act, by year. Healthcare.gov Web site.
http://www.healthcare.gov/law/timeline/full.html. Accessed January 4, 2012.
Healthcare.gov. The Center for Medicare and Medicaid Innovation: opportunities for prevention and health promotion
[draft memorandum]. Healthcare.gov Web site. http://www.healthcare.gov/prevention/nphpphc/advisorygrp/cmmiprevention-health-promotion-10032011.pdf. Accessed January 4, 2012.
Healthreform.GOV Web site. Health insurance reform and breast cancer: making the health care system work for women.
http://www.healthreform.gov/reports/breastcancer/breastcancer3.pdf. Accessed January 23, 2012.
Hoverman JR, Cartwright TH, Patt DA, et al. Pathways, outcomes, and costs in colon cancer: retrospective evaluations in
two distinct databases. J Oncol Pract. 2011;7(suppl 3):52s-59s.
Hsiao CJ, Hing E, Socey TC, Cai B. Electronic Medical Record/Electronic Health Record Systems of Office-based
Physicians: United States, 2009 and Preliminary 2010 State Estimates. Hyattsville, MD: National Center for Health
Statistics, Centers for Disease Control and Prevention; 2010.
Institute of Medicine (IOM). Cancer survivorship facts and figures. IOM Web site.
http://www.iom.edu/~/media/Files/Report%20Files/2005/From-Cancer-Patient-to-Cancer-Survivor-Lost-inTransition/factsheetfactsandfigures.pdf. Accessed January 9, 2012.
Institute of Medicine (IOM). From cancer patient to cancer survivor: lost in transition. IOM Web site.
http://iom.edu/Reports/2005/From-Cancer-Patient-to-Cancer-Survivor-Lost-in-Transition.aspx. Accessed January 4, 2012.
Kanas G, Morimoto L, Mowat F, et al. Use of electronic medical records in oncology outcomes research.
ClinicoEconomics Outcomes Res. 2010;2:1-14.
29
Bibliography (cont)
Kozlowski S, Woodcock J, Midthun K, Sherman RB. Developing the nation's biosimilars program. N Engl J Med.
2011;365(5):385-388.
Kuzner W. Payer trends in oncology: challenges and solutions. Association for Value-Based Cancer Care Web site.
http://www.valuebasedcancer.com/article/payer-trends-oncology-challenges-and-solutions. Accessed January 20, 2012.
Lau EC, Mowat SF, Kelsh MA, et al. Use of electronic medical records (EMR) for oncology outcomes research: assessing
the comparability of EMR information to patient registry and health claims data. Clin Epidemiol. 2011;3:259-272.
Mehta NB, Partin MH. Electronic health records: a primer for practicing physicians. Cleve Clin J Med. 2007;74(11):826-830.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™).
Palliative care. Version 2.2011. http://www.nccn.org/professionals/physician_gls/pdf/palliative.pdf.
Accessed January 4, 2012.
National Quality Forum (NQF). Care coordination practices & measures. NQF Web site.
http://www.qualityforum.org/projects/care_coordination.aspx. Accessed January 4, 2012.
National Quality Forum (NQF). Palliative & hospice care: framework and practices. NQF Web site.
http://www.qualityforum.org/Projects/n-r/Palliative_and_Hospice_Care_Framework/Palliative___Hospice_Care__
Framework_and_Practices.aspx. Accessed January 4, 2012.
National Quality Forum (NQF). Palliative and end-of-life care. NQF Web site.
http://www.qualityforum.org/Topics/Palliative_and_End-of-Life_Care.aspx. Accessed January 4, 2012.
Neubauer MA, Hoverman JR, Kolodziej M, et al. Cost effectiveness of evidence-based treatment guidelines for the
treatment of non-small-cell lung cancer in the community setting. J Oncol Pract. 2010;6(1):12-18.
Nutting PA, Crabtree BF, Miller WL, et al. Transforming physician practices to patient-centered medical homes: lessons
from the National Demonstration Project. Health Aff (Millwood). 2011;30(3):439-445.
30
Bibliography (cont)
Partridge AH, Avorn J, Wang PS, Winer EP. Adherence to therapy with oral antineoplastic agents. J Natl Cancer Inst.
2002;94(9):652-661.
Rau J. Concerns about costs rise with hospices’ use. New York Times. June 28, 2011:D1.
Reinke T. Plans and oncologists don't see eye to eye on prior authorization. Manag Care. 2011;20(9):14-16.
http://www.managedcaremag.com/archives/1109/1109.medmgmt.html. Accessed January 29, 2012.
Senior Journal.com. Hospice care increasing but cost of dying still very costly for Medicare. Senior Journal.com Web site.
http://www.seniorjournal.com/NEWS/Eldercare/2010/20101011-HospiceCareIncreasingBut.htm. Published October 11,
2010. Accessed January 4, 2012.
Sprandio JD. Oncology patient-centered medical home and accountable cancer care. Commun Oncol. 2010;7:565-572.
Zelenetz AZ, Ahmed I, Braud EL, et al. NCCN biosimilars white paper: regulatory, scientific, and patient safety perspectives.
J Natl Compr Canc Netw. 2011;9(suppl 4):S1-22.
31