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Conference Coverage

Ensuring Quality on the Path to Cancer Care Reform

May 03, 2021

At the 2021 Community Oncology Alliance (COA) Annual Conference, a panel of experts discussed the future of cancer care reform and the development of models that ensure quality.

The panel, again moderated by Bo Gamble, examined the Oncology Medical Home (OMH) within the Oncology Care Model (OCM) 2.0.

Participating in the panel alongside Mr Gamble were Michael Diaz, MD, director of patient advocacy and assistant managing physician, Florida Cancer Specialists & Research Institute, and Lalan Wilfong, MD, executive vice president, Value-Based Care & Quality Programs, Texas Oncology.

The conversation started with a review of past care models, including the oncology-based Patient-Centered Medical Home Model, the COME HOME Model, and the recent Oncology Care Model.

Highlighting the growth of reform models in oncology care, Mr Gamble stated that, as of September 2020, there were 35 unique reform models in cancer care in the United States, two of which are employer-based. Dr Wilfong touched on the inequity in the distribution of value-based care models, payment reform, and oncology care in the Unites States, where some states have up to 7 models while others have none.

“Change is absolutely needed in cancer care. Everyone is frustrated,” explained Dr Diaz.

“You've got those that are frustrated about the rising cost of health care, which by the way, also includes cancer care teams. However, there's not been a full agreement on the definition of quality of value and the best way to achieve both of those,” he continued.

When looking toward the future of reform, Mr Gamble noted that there needs to be a good structure put in place that allows for flexibility and promotes transparency.

“Reform should also add efficiency. If we add reform, but add burden on the care teams, on the patients, on the payers, on the employers, that's not a good reform. As we reform, we should make things more efficient for everyone,” said Dr Wilfong.

“There's no one single solution. There's no simple pill that will work for everyone. However, there is a fairly clear path we believe, for all to get there, and with a cancer patient benefiting the most. The path is to build a new cancer care system for all one block at a time,” said Dr Diaz.

“The way we're going to do this is by working together. We have to have an effective and efficient communication. That's key to anything that we do. Without communication, we can't have collaboration. We have to be able to collaborate to be able to move forward. More specifically, we need to agree on the fundamental elements for the care,” added Dr Wilfong.

The panel noted that all these models should have three parts: the care we provide, a payment methodology, and quality measures to show that the care being provided is of good value and quality.

In order to ease the burden on care teams, physicians, and patients, there need to be building blocks for future models that can be modified based on preference of the stakeholders involved. Additionally, the panel emphasized the importance of efficient communication and collaboration when looking toward to the future.

As the new OMH is being developed, it is being shared and presented as a standard base for high-quality cancer care. The panel touched on the importance of the OMH in OCM 2.0. First, it is facilitating a standard recognition of quality cancer care, using seven variables. These seven variables are patient engagement; availability and access to care; evidence-based pathways; equitable and team-based care; quality improvement; goals of care, palliative and end-of-life discussion; and chemotherapy safety.

Additionally, the OMH must facilitate collaboration. COA and ASCO are enacting such collaboration by working together to present, educate, recruit, and guide commercial insurance payers with some of their practices in this program.

Another important aspect of the OMH is that it has a limited a set of quality measures for the practice related to the patients. The goal is to combine claims data with clinical outcomes data into a repository that provides proof to the value of care delivery.

“We're working with ASCO to not only promote this model with colleagues, but also with payers. We'll also work with ASCO afterwards when we start the process to continue the growth, maturity, development, and identification of the oncology medical home, and the measures that go with it. We're excited about joining forces with them,” said Mr Gamble.—Janelle Bradley

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