In a room where some were speaking, others were working, and everyone was listening, one thing became clear, and it was crystalized by Gabrielle Rocque, MD with a quote attributed to Lord Kelvin: “If you cannot measure it, you cannot improve it.”
Though most understand the value of measurement in their professional lives, it is hard to put a high priority on measurement when it comes to improving value-based care. But that is exactly what is at the center of the benefits, and challenges, of the Oncology Care Model. At this August event, care providers, administrators and national experts hashed out the status and impact of OCM at a one-day event in Atlanta. Georgia CORE hosted the event in partnership with the Association of Community Cancer Centers (ACCC) and the Georgia Society of Clinical Oncology, and Pfizer Oncology sponsored it.
The Center for Medicare & Medicaid (CMS) Innovation Center is developing new payment and delivery models designed to improve the effectiveness and efficiency of specialty care. Among those specialty models is the Oncology Care Model (OCM), which aims to provide higher quality and more highly coordinated oncology care at the same or lower cost to Medicare. In 2016, a handful of practices in Georgia received grants from CMS to enter into payment arrangements that include financial and performance accountability for episodes of care surrounding chemotherapy administration to cancer patients.
CMS is also partnering with commercial payers in the model. The practices participating in OCM are acting as pilot programs and have committed to providing enhanced services to Medicare beneficiaries such as care coordination, navigation, and national treatment guidelines for care, while providing CMS with data to inform this ongoing process which will impact everyone in the medical industry in the very near future.
The Georgia CORE gathering in 2018 included the sharing of challenges of both being able to afford the enhanced services, and also the technical difficulties of providing the data. Dr. Roque, however, presented evidence from her work at the University of Alabama in Birmingham to show that process measures, indeed, can be used to influence practice.
“All of our measures went in the direction we wanted,” she offered. “Better symptom management and more navigation touch points led to decreased ER visits.”
The more than 40 attendees from all over the state also heard from Kavita Patel, MS, MD, FACP, Nonresident Fellow, Brookings Institution. Dr. Patel was a contractor that helped design the OCM, so she not only gave enlightening background on the model, she was able to shed light on where it is going.
“If you are in the OCM – hold tight! Try to thrive,” Dr. Patel encouraged. “The infrastructure you’re building you’ll have to have …. no matter who your payer is.”
Panel discussions were filled with robust dialogue and discovery. Lessons learned were shared by Blair Burnett, ACCC; Bo Gamble, Community Oncology Alliance; James Hamrick, MD, MPH, Flatiron Health (the national technology provider); and Kelly Taylor, MSN, ANP-C, ACHPN, Longstreet Clinic; and facilitated by Bruce Gould, MD, Northwest Georgia Oncology Centers. Janice Hopkins, MBA, MSN, Harbin Clinic and Harshav Vyas, MD, Cancer Center of Middle Georgia spoke from the trenches during a case study panel discussion, and Krupa Paranjpe, Pharm.D., Pfizer, explored the question: what else can you do with the data?
“While Georgia’s participating practitioners learned much from each other about the process and status of OCM from experts, it became evident that more questions are coming,” concluded Nancy Paris, President and CEO of Georgia CORE. “This convening once again highlighted the strength of the Georgia CORE network -- that we are better together when we share what we know, even as we are learning ourselves, in the spirit of improving cancer care in our state.”
Click the links below to access the speakers' presentations. Photos from the event can be found at GeorgiaCORE.org.
From Volume to Value by Kavita Patel, MS, MD, FACP, Nonresident Fellow, Brookings Institution
Our Best Care Forward-Health IT & Data by Krupa Paranjpe, Pharm.D., Pfizer
OCM Georgia by Gabrielle Rocque, MD, University of Alabama at Birmingham