Tag Archives: value-based cancer care

Navigation Metrics & Value-Based Care: Measuring Up

By Tricia Strusowski, RN, MSN

Compass pointing at answers-SMALLAs the move to value-based care and Alternative Payment Models (APMs) continues, oncology patient navigators need to become more business savvy and have a full understanding about value-based cancer care metrics.  Case in point: Medicare’s Oncology Care Model (OCM) pilot, the first oncology-specific alternative payment model developed by the Center for Medicare and Medicaid Innovation (CMMI). Data collection and reporting metrics are integral elements of this five-year pilot program, which seeks to achieve higher quality, more highly coordinated care, and smarter spending.

The challenge: Navigation programs lacked strong evidence-based metrics to demonstrate the impact of navigation on the key areas of quality, coordination, and cost-effectiveness.

The good news: the Academy of Oncology Nurse & Patient Navigators (AONN+) recently released 35 evidenced-based metrics in the key categories of patient experience, clinical outcomes, and return on investment.

These metrics were developed using the AONN+  evidence-based Navigation General Certification Domains:

  • Community Outreach and Prevention
  • Coordination of Care/Care Transitions
  • Patient Advocacy/Patient Empowerment
  • Psychosocial Support Services/Assessment
  • Survivorship/End of Life
  • Professional Roles and Responsibilities
  • Operations Management/Organizational Development/Healthcare Economics
  • Research and Quality Performance Improvement

The metrics were developed so that any cancer program or practice can utilize them regardless of the navigation model in place.  The goal in providing these standard metrics is for cancer programs and practices to use them “as a baseline to prove the efficacy and sustainability of their [navigation] programs.”1 Learn more and access metrics.

Partnering to Advance Value-Based Cancer Care
As oncology providers work to improve care coordination and demonstrate delivery of patient-centered, efficient, quality care, patient navigators can play an important role in establishing connections by partnering with physician practices.

For example, navigators can integrate with physician practices to:

  • Increase efficiency and timely access to services by providing comprehensive assessments and referrals to appropriate disciplines
  • Reinforce patient education and empowerment through decision aids and patient appointment checklists
  • Create standing order sets, physician profiles, pathways, and guidelines
  • Increase support for clinicians, i.e., provide early discussions about palliative care, goals of care, advance care planning, and pre-habilitation
  • Increase contacts with “frequent flyers” to decrease ER visits and avoidable admissions
  • Provide automatic referrals to financial counseling at time of diagnosis (generate self-referral reports)

On Thursday, March 30, I will present a more in-depth look at the potential for “Creating Partnerships Between Oncology Nurse Navigators & Oncology Practices” in a session at the ACCC 43rd Annual Meeting, CANCERSCAPE.  The oncology landscape continues to evolve at a rapid pace.  I believe now is the time to explore how navigators can support value-based care initiatives with physician practices, as we all work to keep patients at the center of care delivery.

I hope to see you at CANCERSCAPE, March 29-31, 2017, in Washington, D.C.

Reference

1 Strusowski T, Sein E, Johnston D. Academy of Oncology Nurse & Patient Navigators Announces Standardized Navigation Metrics. J Oncol Nav Survivorship. 2017; 8(2):62-68.

_______________________________________________________________

ACCC member Tricia Strusowski, RN, MSN, is a consultant with Oncology Solutions, LLC, with 20 years of experience in patient navigation.

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.