Updates to the ASCO Patient-Centered Oncology Payment Model

Ward, Jeffery C.; Bourbeau, Brian; Chin, A. H.; Page, Ray D.; Grubbs, Stephen S.; Kamin, Deborah Y.; Green, Sybil R; Rappaport, Mary

doi:10.1200/jop.19.00776

Cited by 7 publications

(7 citation statements)

References 13 publications

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“…The refinement of our CSR model is ongoing, and the final model will be evaluated to assess its ability to predict acute healthcare utilization among oncology patients. The development of such a tool is increasingly important, even beyond the pandemic, as provider-payer partnerships seek to improve the quality of cancer care while decreasing costs [8,9]. Importantly, despite a robust nurse navigation program available to all our oncology patients, 33% of patients had additional needs uncovered through outreach during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Risk stratification and outreach to hematology/oncology patients during the COVID-19 pandemic

Osterman

Triglianos

Winzelberg

et al. 2020

Support Care Cancer

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Purpose Cancer patients have many medical and psychosocial needs, which may increase during the COVID-19 pandemic. We sought to (1) risk-stratify hematology/oncology patients using general medicine and cancer-specific methods to identify those at high risk for acute care utilization, (2) measure the correlation between two risk stratification methods, and (3) perform a telephone-based needs assessment with intervention for high-risk patients. Methods Patients were risk-stratified using a general medical health composite score (HCS) and a cancer-specific risk (CSR) stratification based on disease and treatment characteristics. The correlation between HCS and CSR was measured using Spearman's correlation. A multidisciplinary team developed a focused needs assessment script with recommended interventions for patients categorized as high-risk by either method. The number of patient needs identified and referrals for services made in the first month of outreach are reported. Results A total of 1697 patients were risk-stratified, with 17% high-risk using HCS and 22% high-risk using CSR. Correlation between HCS and CSR was modest (ρ = 0.41). During the first month of the pilot, 286 patients were called for outreach with 245 contacted (86%). Commonly identified needs were financial difficulties (17%), uncontrolled symptoms (15%), and interest in advance care planning (13%), resulting in referral for supportive services for 33% of patients. Conclusion There is a high burden of unmet medical and psychosocial needs in hematology/oncology patients during the COVID-19 pandemic. A telephone-based outreach program results in the identification of and intervention for these needs; however, additional cancer-specific risk models are needed to improve targeting to high-risk patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk stratification and outreach to hematology/oncology patients during the COVID-19 pandemic

Osterman

Triglianos

Winzelberg

et al. 2020

Support Care Cancer

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“…Patient-directed end of life care and 4. Quality of care performance [31]. Expanding acute home-based care was not an explicit component of the PCOP model, but a cost-effective and equitable delivery model would complement its main goals.…”

Section: Buyer Powermentioning

confidence: 99%

Acute home-based care for patients with cancer to avoid, substitute, and follow emergency department visits: a conceptual framework using Porter’s Five Forces

et al. 2022

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Background Patients with cancer constitute a large and increasing segment of patients who receive unscheduled hospital-based care due to treatment-related symptoms and disease progression. The initial hospital-based touchpoint for these unscheduled hospitalizations is often the emergency department. Traditional models of emergency department and inpatient hospital-based care are saturated and incapable of scaling to accommodate the future, increased needs projected for this population. New models of care are necessary to address this gap. Acute home-based care is a promising tool potentially providing patient-centric, efficient care to eligible patients. Methods We applied Porter’s Five Forces framework that addresses the bargaining power of buyers and suppliers, threat of substitutes and new entrants, and industry rivalries plus the sixth force of regulation to clarify the factors that will promote or challenge the adoption of a home-based cancer care referral model before or following emergency department visits. Exploring this framework provides insights into the complexities of scaling an acute home-based cancer care model and highlights ways for health systems including hospitals, emergency departments, physician groups, and individual emergency physicians and oncologists to optimize their roles in this emerging model of care. Results We found that current workforce shortages, as well as workflow, infrastructure, and regulatory complexities, pose major challenges that unless carefully addressed may restrict the growth of acute home-based cancer care. Additional uncertainties persist around appropriate payment models and the competitive landscape. Key promoting factors include the recognized need in the cancer community and among payers for new models to decrease unscheduled hospitalizations and emergency department visits as well as the uptake of home-based and technology-enabled solutions during the COVID-19 pandemic. A better understanding of these forces helps to clarify the risks and opportunities as new entrants build their programs. Conclusions Acute home-based cancer care is a promising tool to complement traditional outpatient clinics, emergency departments, and inpatient hospital-based models of cancer care. New technologies and policies increasingly enable a broader scope of cancer care in the home setting.

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“…According to the Agency for Healthcare Research and Quality, the direct cost of cancer care in the United States in 2017 was $105.5 billion. 1 As the cost of drugs and overall cost of cancer continue to increase, 2 there has been increased interest in optimizing the value of care. 3 The application of value-based payment models has been challenging because of heterogeneity in how practices deliver cancer care.…”

Section: Introductionmentioning

confidence: 99%

Oncology Medical Home: ASCO and COA Standards

Woofter¹,

Adelson

Bowman

et al. 2021

JCO Oncology Practice

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PURPOSE: To provide Standards on the basis of evidence and expert consensus for a pilot of the Oncology Medical Home (OMH) certification program. The OMH model is a system of care delivery that features coordinated, efficient, accessible, and evidence-based care and includes a process for measurement of outcomes to facilitate continuous quality improvement. The OMH pilot is intended to inform further refinement of Standards for OMH model implementation. METHODS: An Expert Panel was formed, and a systematic review of the literature on the topics of OMH, clinical pathways, and survivorship care plans was performed using PubMed and Google Scholar. Using this evidence base and an informal consensus process, the Expert Panel developed a set of OMH Standards. Public comments were solicited and considered in preparation of the final manuscript. RESULTS: Three comparative peer-reviewed studies of OMH met the inclusion criteria. In addition, the results from 16 studies of clinical pathways and one systematic review of survivorship care plans informed the evidence review. Limitations of the evidence base included the small number of studies of OMH and lack of longer-term outcomes data. More data were available to inform the specific Standards for pathways and survivorship care; however, outcomes were mixed for the latter intervention. The Expert Panel concluded that in the future, practices should be encouraged to publish the results of OMH interventions in peer-reviewed journals to improve the evidence base. STANDARDS: Standards are provided for OMH in the areas of patient engagement, availability and access to care, evidence-based medicine, equitable and comprehensive team-based care, quality improvement, goals of care, palliative and end-of-life care discussions, and chemotherapy safety. Additional information, including a Standards implementation manual, is available at www.asco.org/standards .

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Updates to the ASCO Patient-Centered Oncology Payment Model

Cited by 7 publications

References 13 publications

Risk stratification and outreach to hematology/oncology patients during the COVID-19 pandemic

Risk stratification and outreach to hematology/oncology patients during the COVID-19 pandemic

Acute home-based care for patients with cancer to avoid, substitute, and follow emergency department visits: a conceptual framework using Porter’s Five Forces

Oncology Medical Home: ASCO and COA Standards

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