Transcript Michigan OMH Meeting - Community Oncology Alliance

ONCOLOGY MEDICAL HOME
ACCREDITATION
FRIDAY MARCH 26, 2015
Bo Gamble, COA, Dir. of Strategic Practice Initiatives
Laura Stevens, IOBS, Program Director
Daniel McKellar, MD, FACS, Chair, Commission on Cancer
ONCOLOGY MEDICAL HOME
ACCREDITATION
History of this Program
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
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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.
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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
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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
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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
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ONCOLOGY MEDICAL HOME
ACCREDITATION
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.
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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 issues
Advocacy
Research
Administrative services
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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:
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Accreditation questionnaire
Policies
Procedures
19 OMH Measures
Discussions on workflow
Chart review
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CoC OMH Accreditation Pilots
Practice
Oncology Hematology Care, Cincinnati
Center for Cancer and Blood Disorders, Fort Worth
Dayton Physicians Network
Austin Cancer Center
Oncology Hematology Associates of Springfield
M.D. P.C.
Northwest Georgia Oncology Center
Space Coast Cancer Center
Hematology Oncology Associates of Central New
York
New Mexico Oncology Hematology Center
Maine Center for Cancer Medicine
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OH
TX
OH
TX
MO
Date(s)
February 24th
February 24th
February 25th
February 25th
March 3rd
GA
FL
NY
March 5th
March 20th
March 31st
NM
ME
April 14th
April 15th
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Reminder….
Pilot
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Components:
 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
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Components:
 Eligibility
• The entire cancer care team supports and promotes the OMH
• Certified EHR
• Submits data that demonstrates compliance
 Domains
• #1 Patient Engagement
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Patients educated on OMH
Financial counselors assist patients
Practice has a patient portal
Patients have access to their medical information
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Components:
 Domains
• #2 Expanded Access
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A new patient can easily access their OMH
An established patient can easily access their OMH
• #3 Evidenced Based Guidelines
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Treatments are according to guidelines
Clinical trials are offered through the practice
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Components:
 Domains
• #4 Comprehensive Team Based Care
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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
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Practice assures completeness of clinical data
Participates in standard patient satisfaction surveys
Quality improvement processes
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Emphasis on….
Value
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Must be….
Meaningful
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Assistance
 IT Vendors
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Altos
Elekta
FlatIron
IKnowMed
NantHealth
Unlimited Systems
 Legislation – SGR Repeal, H.R 1416
 Grants – CMMI
 Pilot programs w/private payers
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Aetna
United
BCBS
Humana
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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.
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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]
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Questions/Comments
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ONCOLOGY MEDICAL HOME
An initiative for all stakeholders