ONCOLOGY MEDICAL HOME ACCREDITATION FRIDAY MARCH 26 2015

ONCOLOGY MEDICAL HOME ACCREDITATION FRIDAY MARCH 26, 2015 Bo Gamble, COA, Dir. of Strategic Practice Initiatives Laura Stevens, IOBS, Program Director Daniel Mc. Kellar, 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 Oncology Medical Home 3

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. Oncology Medical Home 4

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 Oncology Medical Home 5

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 Oncology Medical Home 6

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 Oncology Medical Home 7

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. Oncology Medical Home 9

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 Oncology Medical Home 10

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 Oncology Medical Home 11

Co. C 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 Oncology Medical Home ST OH TX MO Date(s) February 24 th February 25 th March 3 rd GA FL NY March 5 th March 20 th March 31 st NM ME April 14 th April 15 th 12

Reminder…. Pilot Oncology Medical Home 13

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 Oncology Medical Home t raf D 14

Components: Eligibility • The entire cancer care team supports and promotes the OMH • Certified EHR • Submits data 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 Oncology Medical Home t raf D 15

Components: 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 Oncology Medical Home t raf D 16

Components: Domains • #4 Comprehensive Team Based Care – – – The medical oncologist directs the team The practice coordinates with other provider teams Coordinates with other Co. C 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 Oncology Medical Home t raf D 17

Emphasis on…. Value Oncology Medical Home 18

Must be…. Meaningful Oncology Medical Home 19

Assistance IT Vendors • • • Altos Elekta Flat. Iron IKnow. Med Nant. Health Unlimited Systems Legislation – SGR Repeal, H. R 1416 Grants – CMMI Pilot programs w/private payers • • Aetna United BCBS Humana Oncology Medical Home 20

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. Oncology Medical Home 21

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 OMHaccreditation@facs. org Oncology Medical Home 22

Questions/Comments Oncology Medical Home 23

ONCOLOGY MEDICAL HOME An initiative for all stakeholders