Medical groups participating in the bundled payments program for cancer care are eager to innovate care, exchange ideas with other providers, and improve communication with patients and families.
"Excited" was the first word Eric Whitman, MD, medical director of Atlantic Health System's Carol G. Simon Cancer Centers in New Jersey, used to describe his reaction to Atlantic Health's acceptance into the Oncology Care Model program.
Atlantic Medical Group was among nearly 200 practices chosen by the Centers for Medicare & Medicaid Services to participate in the five-year bundled-payment demonstration that launched July 1.
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"We actually heard in April that we'd been chosen, but [CMS] said there were a lot of things you had to do between being chosen and being accepted. And we had to decide we wanted to do it as well," he told me.
"In the end, our group felt that this was a very exciting new way to go forward in cancer care. We're essentially doing research into how to provide care and how to, most of all, communicate better with our cancer patients and their families. The government is funding us to investigate new ways of doing that," he says.
Comparing Notes
The benefits extend beyond the individual medical groups and their patients. "One of the fascinating things built into the back end of the grant is that you must share your ideas and experiences," Whitman notes.
"We can all learn from each other. And if someone in, say, Kansas does something differently that seems to resonate with our patients or with us, we'll hear about it through the grant mechanism and can try it as well."
For the 12 participating practices affiliated with the US Oncology Network, the collaboration has already begun, through a comprehensive program with innovative tools and resources designed to help groups optimize the OCM experience and transition to value-based care.
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"The move to value-based care will completely change the landscape of cancer care in the future, impacting all aspects of care delivery and reimbursement," said J. Russell Hoverman, MD, medical director of managed care at the USON and an oncologist with Texas Oncology, in an announcement.
The USON has spent the past six months developing a support program to help members learn about care and support team structure, developing and deploying patient care paths, technology and reporting needs, financial models for incentive alignment, and revenue cycle management.
Upping Their Game
All practices that participate in OCM are required to enhance their services to provide patient-centric oncology care. Some of these features, such as 24/7 access, many practices offer already.
The new work will vary depending on a practice's current strength and opportunities.
"The biggest thing for us, I believe, is going to be not just having electronic health records installed, which we're in the process of doing," Atlantic's Whitman says, "but having them configured in such a way to make sure we're communicating all of the desired data points to patients."
"On the back end, we're collecting the data we need to figure out if what we're changing has made any difference."
Fellow participant Henry Ford Medical Group is also eager to take its existing best practices to the next level.
In particular, Henry Ford announced last week a partnership with precision medicine software company, Syapse, to offer targeted cancer treatments to Henry Ford patients in Detroit and beyond.
"I think it's fair to say that this program is so new that it's going to evolve fairly quickly," Whitman says.
"There aren't a lot of hard and fast rules… There are big structures. But how you get to that structure and exactly how you implement it is going to honestly be the exciting part for everyone."
Debra Shute is the Senior Physicians Editor for HealthLeaders Media.