Tag Archives: ACCC 42nd Annual Meeting

ACCC Annual Meeting: Five Key Takeaways

by Amanda Patton, ACCC Communications

ACCC 42nd Annual MeetingNearly 500 oncology professionals gathered in Washington, D.C., last week for the 42nd ACCC Annual Meeting, CANCERSCAPE. Throughout sessions centered on policy, value, and quality, attendees heard a recurrent message: Your experience, perspective, and input on the issues of value-based care, quality measures, and outcomes are essential as the healthcare system and oncology transition to the new world of alternative payment models and value-based care.

From ACCC Capitol Hill Day last Wednesday throughout the meeting sessions, attendees were urged to educate policymakers and payers about the real-world processes involved in delivering quality cancer care.

In the meeting’s opening session, Congressman Rick Nolan (MN-D)  called out the vital role ACCC members can play in helping educate legislators and policymakers, “No one can articulate need, challenges, potential to ultimately cure cancer [better] than the people in this room today,” he said.

Can precision medicine be reconciled with value-based care? “Absolutely” said Kavita Patel, MD, MS, of the Brookings Institution.  Oncology already delivers personalized (or precision) medicine through targeted therapies for some cancers, she pointed out. Communicating about the oncology care process so that policymakers understand real-world cancer care delivery is imperative, Patel said. Part of that conversation should aim to help policymakers understand the demanding intuitive thought process that is part of today’s oncology care, along with the tremendous amount of information cancer care providers must keep up with given the pace and variety of emerging therapies. “It’s not writing prescriptions,” she said.

Five Key CANCERSCAPE Takeaways

High-level meeting takeaways that interconnect value, policy, and quality include:

  1. Alignment. For value and quality measures to work in oncology, alignment among payers, providers, and patients is essential.
  2. Put your data to work. Cancer programs and practices are finding ways to harness their data to improve quality patient-centered care and reduce costs. In a presentation on Collaboration Across Specialties to Improve Care and Curb Costs, Matthew Manning, MD,  from Cone Health demonstrated how his program used data to identify “hotspotters,” assess gaps in care, improve outcomes, and reduce costs.
  3. Communicate. Support conversations across silos and among stakeholders. Engage with patients to understand their goals of care and to define value and quality. While value frameworks are generic, “all patients are different” agreed panelists in a Town Hall discussion on Value Framework Tools.
  4. Be proactive. Don’t wait until USP Chapter 800 goes into effect to assess your facilities readiness. Don’t wait until HRSA issues its final 340B mega-regulation. Take steps today to assess your program’s compliance. “Be prepared” was also the message in a Biosimilars Update from Nisha Pherwani, PharmD, BCOP, clinical director of Oncology, Cardinal Health. She urged attendees to:
    • Understand the FDA approval process for biosimilars
    • Provide a concise review to your P&T committee
    • Review the FDA guidances on biosimilars
    • Stay tuned for more on how interchangeability will impact regulations.
  5. Speak up. Oncology providers can best articulate the care they provide and the issues impacting care delivery. Leadership in oncology has to step forward to help define quality and value and inform policy. Work with ACCC to make your voice heard.

This week’s CMS release of a proposed rule designed to test new Medicare Part B drug payment models makes clear the critical need for the oncology community stay on top of what is happening among policymakers in Washington, D.C.  ACCC has voiced strong opposition to CMS’s proposal. Among other concerns, ACCC points to the lack of opportunity for stakeholder input on the development of this proposal.

ACCC urges its members speak up and ask Congress to stop the CMS Medicare Part B Drug Payment Model.  Click here to contact your legislators.

Annual Meeting Highlight: Medicare Update & What to Expect in 2016

By Amanda Patton, ACCC Communications

ACCC 42nd Annual Meeting-ConwayAt the ACCC 42nd Annual Meeting last week, Lindsay Conway of The Advisory Board Company updated attendees on Medicare payments and what to expect in 2016.  Not surprisingly, her presentation touched on issues related to the meeting’s central themes of policy, quality, and value.

Two examples of the forward momentum in quality this year will be “testing” new oncology quality measures through PCHQR Quality Reporting Measures and CAHPS for Cancer Care.  Field testing for the CAHPS for Cancer Care is wrapping up, Conway said, and we can expect to see the CAHPS trademark on three oncology-specific surveys this summer.  Specifically, we will see a survey for surgical oncology, a survey for radiation oncology, and a medical oncology survey. Each survey will consist of about 85 questions and will likely reflect five CAPHS domains, including:

  1. Effective Communication
  2. Shared Decision Making
  3. Enabling Patient Self-Management
  4. Technical Communication
  5. Access

Looking ahead, Conway noted that new policies are supporting population health goals while also slowly moving forward with payment for value. As examples, she cited recent Medicare policies related to biosimilars, advance care planning, and lung cancer screening.

As cancer programs plan strategically for the future, Conway suggests keeping an eye on the following:

  • Payment equalization—which is gaining momentum
  • Progression of site-neutral payment policies
  • Physician practice acquisition—the equation is becoming increasingly complex from both the hospital and the physician practice perspectives
  • Alternative payment models (APMs), in particular the Center for Medicare and Medicaid Innovation (CMMI) Oncology Care Model.

The CMS OCM initiative, which will pilot a value-based reimbursement model in oncology, is on everyone’s radar screen, as the oncology community awaits the agency’s announcement of practices selected for participation. Conway acknowledged that the OCM model is complex and that many questions remain about how CMMI will implement the model.

The ultimate benefit for those participating in the OCM will not be financial, according to Conway. The benefits for participants will be strategic, e.g., new data sets, benchmarks, more data about the patients being served, the opportunity to develop competencies in operating in a risk-based environment, and having a voice in the development of new risk-based models in oncology.

Rep. Nolan Praises Advocacy Efforts of ACCC Members

by Amanda Patton, ACCC Communications

Rep. Richard Nolan opens ACCC 42nd Annual Meeting

Rep. Richard Nolan opens ACCC 42nd Annual Meeting

Congressman Richard “Rick” Nolan (MN-D) opened the ACCC 42nd Annual Meeting on Thursday paying tribute to ACCC membership. “I want to thank you for all that you do,” he said.

“You are part of the team that comes together to be there for people at the most challenging and emotionally difficult and troubling times in their lives. . . Thanks to the dedication and hard work of people like you so much progress is being made in [the fight] against cancer.”

In an ideal transition from ACCC Capitol Hill Day to CANCERSCAPE Annual Meeting sessions focused on policy and key drivers of change, Representative Nolan told attendees coming to Washington is critical, “I know it’s not easy, but it is so important because as a practical matter lending your voices, your knowledge, your perspective is unbelievably important.”

He spoke movingly about the impact of cancer in his own family. Congressman Nolan lost his father to cancer, and an aunt—who was an inspiration for his political career—also died from cancer at age 54.

Last January, he announced that his youngest daughter had been diagnosed with stage 4 non-smoking lung cancer. She is “a high spirited, very determined, and very, very health conscious young woman,” Nolan said. “Thanks to people’s prayers and advances in medical science she’s doing better. She is still with us fighting the good fight.”

His daughter’s struggle inspired Nolan to establish the Congressional Lung Cancer Caucus, along with co-founders Lois Capps (CA-D) and Frank LoBiondo (NJ-R).

Because nearly everyone has someone in their lives who has been touched by cancer, Congressman Nolan is optimistic that “we can find nonpartisan almost unanimous agreement to find better funding for the research needed to end this terrible scourge.”

Advocacy efforts such as ACCC Capitol Hill Day are critical he said. It’s important to tell your story because “no one can articulate need, challenges, potential to ultimately cure cancer [better] than the people in this room today.”

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Stay tuned for Annual Meeting key takeaways.

Advocacy in Action—ACCC Capitol Hill Day

by Amanda Patton, ACCC Communications

ACCC members put advocacy into action yesterday in more than 84 meetings with legislators on Capitol Hill.

Former Senator Norm Coleman addressing ACCC Hill Day

Former Senator Norm Coleman addressing ACCC Hill Day

Starting the day off, participants heard from former Senator Norm Coleman (MN), “The world belongs to those who show up, so thank you for showing up today to make difference.” He urged ACCC members to “Let them know what you’re advocating for is good policy, and you need their help to get it done!”

Nearly 70 ACCC members representing 27 states “showed up” for Hill Day this year. In conversations with legislators throughout the day, they not only advocated for “good policy,” including support for the Cancer Drug Coverage Parity Act (S 1566/HR 2739) and the Planning Actively for Cancer Treatment (PACT) Act (HR 2846). They also shared the story of community cancer care, how their programs are serving patients and their communities, and the challenges they face.

Summing up the experience, ACCC Capitol Hill Day participant Ann Yager, RT (R)(T), Oncology Services Director, Nebraska Medical said, “It’s really about our patients and our ability to care for our patients.”

Throughout the day, participants heard the message: legislators want your help to be informed about the issues affecting your cancer programs, your patients, and your community.

Representative Lois Capps (CA-D)

Representative Lois Capps (CA-D)

During a lunch address to ACCC Hill Day participants, Representative Lois Capps (CA-D), co-sponsor of the PACT Act, spoke about the critical role care planning and coordination play in ensuring patients are supported throughout their treatment.

She also reiterated the importance of helping legislators understand the issues. “A cancer diagnosis is much more than a test result,” she said, [we need to] “educate our colleagues on Capitol Hill” [on the need to support patients through their cancer treatment journey].

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ACCC 42nd Annual Meeting, CANCERSCAPE is underway. Join us today for live stream Town Hall discussion on Value Framework Tools: The Provider Perspective from 12:50 — 1:35 pm EST. Access the Town Hall discussion from the ACCC website.

Navigation Metrics and Value-Based Care

By Tricia Strusowski, MS, RN

Ms. Strusowski recently co-authored an article on “Patient Navigation Metrics” for Oncology Issues, the journal of the Association of Community Cancer Centers. In this guest blog post, she explores this topic in the context of value-based care.

ThinkstockPhotos-467463476Value-based care is a highly coordinated, patient-centered solution to address rising costs, duplication of services, barriers to care, and to help patients receive the care they need. Over the decades, patient navigation standards and core competencies have been established through national organizations. These guidelines and standards have provided an excellent foundation for oncology navigation programs. Metrics are exceedingly important for measuring the success of your patient navigation program. Value-based care (which drives improvements to the delivery of care by requiring improved care at a lower cost) encompasses more than metrics and has the potential to skyrocket your program to a new level.

As we advance present navigation programs, value-based care will be essential; it will incorporate all the key categories from the Institute of Medicine (IOM) report, “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis.”

The conceptual framework from the IOM report includes:

  • Engaged patients
  • Adequately staffed, trained, and coordinated workforce
  • Evidence-based cancer care
  • A learning healthcare IT system for cancer
  • Translation of evidence into clinical practice, quality measurement, and performance improvement
  • Accessible, affordable cancer care

The goal of value-based care is to empower patients to actively participate in their care, which will enhance the patient experience and drive patient-centered outcomes.

How can we support our patients to participate in their care discussions? Some examples include:

  • Provide decision aides including questions to prompt discussion with the patient and his or her healthcare provider
  • Provide patients with educational information that incorporates their preferred learning style, i.e., written, visual, or verbal
  • Mandate health literacy and cultural competency training for our staff
  • Utilize evidence-based tools to identify barriers for patients and their families
  • Create a patient appointment checklist to explain the reason for tests and procedures

The result of value-based care is a patient-centered process in which patients and their families are educated and able to participate in their treatment discussion from time of diagnosis through to survivorship or end-of-life services. By having our patients actively participate in these treatment discussions, value-based outcomes will prevail and advance the level of our patient navigation programs.

Next week, the ACCC 42nd Annual Meeting, CANCERSCAPE, in Washington, D.C., will feature sessions that focus on various facets of value-based care, including a special Town Hall discussion: Value Framework Tools: The Provider Perspective, which will be live-streamed on Thursday, March 3, 2016, from 12:50 pm — 1:35 pm EST. Learn more here.  

USP Chapter <800> — Readiness is All

By Amanda Patton, ACCC, Communications

ThinkstockPhotos-180686516Last week, on February 1, the United States Pharmacopeial Convention (USP) announced publication of the new standard general chapter, <800> Hazardous Drugs – Handling in Healthcare Settings. USP approved an extended official implementation date of July 1, 2018. This gives healthcare facilities a little more than two years to conform to the standard’s requirements.

With Chapter 800, for the first time a USP standard addresses hazardous drug administration, bringing nurses—and not just pharmacists—under its purview. The standard covers all medications specified in the National Institute for Occupational Safety and Health (NIOSH) list of antineoplastic and other hazardous drugs.

“If there is chemotherapy in your organization, then it applies to you. So you better know about USP 800,” says Martha Polovich, PhD, RN, AOCN, Assistant Professor, Georgia State University. “It applies to all healthcare personnel and all entities in which these drugs are present.” In a session on March 4 at the ACCC Annual Meeting, CANCERSCAPE, Dr. Polovich will provide an in-depth look at final USP Chapter 800, what cancer programs need to know about compliance, and why time is of the essence. Dr. Polovich served on the expert panel that helped to write Chapter 800.

Although the implementation is July 2018, “You can’t wait until early 2018 and expect to meet the standard,” Dr. Polovich warns. While some organizations are already in compliance, it may take others that long to get up to speed, according to Dr. Polovich. Some will need to make capital improvements. And because Chapter 800 requires the use of closed-system transfer devices (CSTD) for hazardous drug administration, some will need to acquire CSTD and ensure that staff is fully trained.

USP 800 is an enforceable standard meaning that state boards of pharmacy and other regulatory entities may require compliance with the new standard.

Readiness is All

What should healthcare facilities be doing to prepare for compliance? As a first step, Dr. Polovich suggests a baseline assessment to find out where the organization is not meeting the standard. Using the baseline assessment results, organizations can then prioritize next steps. For example, if major capital improvements are needed, ensure that these are added into the budget planning cycle. Another key piece is identifying a champion who will be responsible for the organization’s safe handling program and be in charge of USP 800 compliance, she says. This individual should be an expert who is knowledgeable about hazardous drug management and prevention of exposure to hazardous drugs. Healthcare facilities also need to identify the drugs in their organization that should be handled as hazardous.

Join us at the ACCC Annual Meeting to hear from Dr. Polovich and other thought leaders on issues impacting quality oncology care delivery today and tomorrow. View the meeting agenda and learn more here.

Getting Engaged

One in an occasional blog series on topics from Oncology Issues, the journal of the Association of Community Cancer Centers.

by Susan van der Sommen, MHA, CMPE, FACHE, ACCC Editorial Committee Chair

ThinkstockPhotos-484468581When first hearing of a cancer diagnosis, I imagine a patient’s mind spinning with a cyclone-like ferocity … Am I going to die? How will I tell my family? What about all of my plans? It’s cancer … of course I am going to die … but how soon? Suddenly, life spins out of control.

Engaging patients in their care can dramatically reduce anxiety by giving back some control. Of course they can’t control the diagnosis, but they can control how they face it – on their terms, with their beliefs, wishes, and desires at the forefront of every decision.

In a recent Oncology Issues article, “Talk to Me: Improve Patient Engagement; Improve Your Cancer Program,” author Chad Schaeffer, MS, FACHE, lays the foundation for developing strategies to connect patients and the decision-making process relating to their care. Improved patient engagement can alleviate some of patients’ burden in feeling as if they are hapless victims of heinous misfortune and allow them to regain some semblance of control over their future. Schaeffer is executive director at the Edwards Comprehensive Cancer Center at Cabell Huntington Hospital, Huntington, WV.

Defining patient engagement in simple, broad terms as “the ongoing and mutually beneficial interaction between patient and providers,” he notes that putting the patients’ needs and aspirations first will improve engagement and, ultimately, satisfaction for all.

What are the goals?

Patients’ treatment goals vary and are individualistic. Some desire to extend life at any cost; others prefer quality over quantity. Many want as little disruption to their daily lives as possible. As Schaeffer points out, evening and weekend hours, though not always pleasing to cancer center staff and physicians, will allow some patients and caregivers the flexibility to carry on with their routine (work, childcare, etc.) while receiving treatment and care at a time that is convenient.

Are we meeting your needs?

Cancer center physicians often struggle with the difficult conversations regarding the “end of life,” resulting, as Schaeffer points out, in decisions that may not coincide with a patient’s wishes. According to an end-of-life study at Stanford University, family members whose loved one died in an “institutional setting” reported poor symptom management, lack of physician communication and patient engagement, and a dearth of emotional support for loved ones and caregivers. Conversely, those who passed with home hospice services reported a considerably higher degree of satisfaction with regard to unmet needs and physician engagement.

Is there something you aren’t telling me?

In addition to reviewing Press Ganey and CGCAHPS surveys, the leaders at the Bassett Cancer Institute in upstate New York have instituted a process where they can – in real time – monitor patient satisfaction. Throughout the course of their treatment, patients are offered a tablet on which they answer a few questions about their care. Questions are flagged so that when a patient expresses dissatisfaction, a member of the leadership team can address the patient’s concern during his or her visit. It gives both the patient and staff an opportunity to more effectively understand what drives patient satisfaction while giving patients an active voice in their care.

Engaging patients from the outset of their diagnosis and throughout their care is critical to their satisfaction and ultimately, as Schaeffer points out, a more effective, patient-centered cancer treatment center.

Patient–centered care is a key focus of the upcoming ACCC Annual Meeting, CANCERSCAPE, March 2-4, in Washington, D.C. Learn more here.

Read the current edition of Oncology Issues here.

ACCC member Susan van der Sommen, MHA, CMPE, FACHE, is Executive Director, DSRIP, Bassett Healthcare Network. She currently serves as chair of the ACCC Editorial Committee.

Collision Ahead? Precision Medicine & Cost

By Amanda Patton, ACCC, Communications

meetings-AM2016-brochure-190x246As researchers and clinicians continue to advance our understanding of the genomic and molecular underpinnings of an increasing number of cancers, oncology finds itself at the “perfect intersection of precision medicine and genomics and concerns about cost,” says Kavita Patel, MD, MS, a Senior Fellow at the Brookings Institution and a primary care physician at Johns Hopkins Medicine.

On March 3 at the ACCC Annual Meeting, Cancerscape, Dr. Patel will provide perspective on whether these forces are on an inevitable collision course—or if there may be a way forward to realize precision medicine’s potential to ultimately reduce costs.

Value  =  ?

A core tenet of healthcare reform is transition to a value-based healthcare system. But, as the oncology community is well aware, different stakeholders have different perceptions of “value.”

“Value to some means reduced costs,” says Dr. Patel. “Others define value as reduced costs with increased quality. Arguably precision medicine is the ultimate in value-based care; it aligns the patients’ needs with the most targeted care, however it might have an increased individual cost.”

“Oncology is one of the few areas in medicine where we actually commonly use precision medicine. For example, for lung cancer we routinely send out tissue for targeted genomic screening and have therapies based on the results,”  says Dr. Patel. The challenge is that science continues to outpace policy.

As oncology transitions to value-based payment models, “the members of the same community that brought us precision medicine—cancer clinicians and researchers—must be the ones who define value in precision medicine,” says Dr. Patel.

Population health must be a part of the value discussion, she says. “We have to do a better job of looking at outcomes and metrics and how we are doing with our patients.” Looking ahead, every oncology practice or cancer center will need to be measuring and demonstrating their impact on population health and patient outcomes. Somehow oncology will have to bring  precision medicine’s individualized approach to treatment into alignment with population health value.

The cancer community must have a voice in the value conversation, Patel stresses, “because it’s important that the people who deliver care in real-time be the people who help define value.”

You’re invited to be part of that conversation. Join us at the ACCC Annual Meeting, Cancerscape, March 2-4, in Washington, D.C. Learn more here.

CANCERSCAPE Session to Demystify Site-Neutral Payment Policy

By Amanda Patton, ACCC Communications

meetings-AM2016-brochure-190x246In recent months MedPAC, the Centers for Medicare & Medicaid Services (CMS), Congress, and the GAO have ramped up attention on the impact of consolidation and integration, shifts in sites of service, and how unequal payment rates across settings of care are affecting Medicare costs.

Adding to the controversy (and confusion) around site-neutral payment as a solution to reducing the Medicare “spend” is the recently passed Bipartisan Budget Act of 2015 at Section 603, “Treatment of Off-Campus Outpatient Departments of a Provider.”

Although the issues surrounding site neutral payment policy are complex, “Section 603 is pretty straight forward,” says Ronald Barkley, MS, JD, of the CCBD Group. “It’s the downstream unintended consequences that cancer programs need to understand.” In a session at the upcoming ACCC Annual National meeting in Washington, D.C., March 2-4, Barkley will demystify site neutral payment policies, lay out pros and cons, and provide a realistic assessment of the potential impact of Section 603. Attendees will leave with a 360-degree understanding of the issues and a “knowledge base to work from” going forward, Barkley said.

Site-neutral payment policies have the potential to affect revenue and budgeting, strategic planning, pro forma development, and 340B Drug Program participation. Thus, a thorough understanding of Section 603 is critical for today’s cancer program leadership.

Time is of the essence, according to Barkley. “There is a window of opportunity to take your message to CMS before [the agency] translates the [Section 603] legislation into regulation.”

Attend the ACCC 42nd Annual Meeting, CANCERSCAPE, from March 2—4, 2016, in Washington, D.C., and gain strategic insight into key drivers of change impacting our evolving oncology care delivery system in sessions focused on Policy, Value, and Quality. Learn more here.  Want to discuss this issue with your elected representatives on Capitol Hill? See what’s planned for ACCC Capitol Hill Day on March 2.

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Originally posted to ACCCBuzz on January 28, 2016.

Why ICD-10 Codes Must Tell Your Patient’s Story

By Amanda Patton, ACCC Communications

meetings-AM2016-brochure-190x246We’re four months post ICD-10 implementation and some are comparing the transition to Y2K—a lot of sound and fury over what ultimately turned out to be a relatively calm transition.

If you think it’s all smooth sailing from here on out, think again. “ICD-10 is nothing like Y2K,” says Cindy Parman, CPC, CPC-H, RCC, Principal, Coding Strategies, Inc. “Moving to ICD-10 is more like having a baby. Once the baby’s arrived the work begins.”

In a session on Friday, March 4 at the ACCC 42nd Annual Meeting, CANCERSCAPE, Parman will be sharing tips for cancer programs to take stock of their ICD-10 transition.

Post implementation, what ICD-10 pain points is Parman seeing in oncology programs?

· Coding errors.  These may be coder mistakes or they may stem from insufficient documentation in the medical record—for example, physicians not providing enough information.
· Productivity.  Working with ICD-10 is taking coders longer because there is more information to sift through and coders may have to go back to physicians with questions.
· Reimbursement issues.  Insurance payers are taking an opportunity to tighten up qualifications for reimbursement. Some ICD-9 codes may have been reimbursed in the past, where the corresponding ICD-10 code will not result in payment. Even smooth transitions to ICD-10 don’t necessarily mean that cancer programs are coding correctly, Parman warns.

“It’s important for cancer programs to understand that ICD-10 is a patient classification system,” says Parman. Used appropriately, the code set will generate the data that tells the patient’s story and ensure that providers are getting credit for all of the care that is being provided. But when codes are missed that story is incomplete.

New payment models will be driven by ICD-10 codes, and capturing all the care provided for patients is critical, Parman says. “The data that cancer programs are collecting today will be used by the Centers for Medicare & Medicaid Services (CMS) to develop future alternative payment models (APMs). If the codes used do not reflect the full scope of services provided, cancer programs won’t be able to go back later and say ‘we left these codes off.’ ”

During her meeting session, Parman will discuss the potential for mining ICD-10 data to measure quality, safety and efficiency, among other indicators. But, she points out, “You can’t mine data you don’t have.”

Join us at the ACCC 42nd Annual Meeting, CANCERSCAPE, from March 2—4, 2016, in Washington, D.C., and gain strategic insight into three key drivers of change impacting our evolving oncology care delivery system: policy, value, and quality. Full session and speaker information available here.

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Originally posted to ACCCBuzz on January 26, 2016.