Tag Archives: healthcare reform

National Oncology Conference—What’s New About “How To”?

by Amanda Patton, ACCC Communications

Something exceptional happened at last week’s ACCC 34th National Oncology Conference.

No, not the exceptional conference attendance of nearly 800 multidisciplinary oncology professionals for a “how to” focus on cancer care delivery.

No, not the exceptional sessions with practical “how to’s” for improving processes, patient satisfaction, quality reporting, data collection, and workflow. And no, not the stellar 2017 Innovator Award winner presentations with their exceptional solutions and actionable takeaways for advancing patient care in the community. And not the Spotlight Sessions, with peer-to-peer sharing of quick-takes on exceptional “how to’s” addressing hot topic issues in oncology care delivery.

The “exceptional” we’re referring to is something else:  A theme heard across multiple conference sessions. Something connecting the past, the present, and the future of cancer care delivery.

What’s New about “How To”?
In this blog post, ACCCBuzz is talking about an “exceptional” theme that surfaced in session after session of the ACCC 34th National Oncology Conference: Improving connections between the “art” and the “science” of medicine to improve care delivery.

At this “exceptional” time in healthcare—with unprecedented uncertainty on ACA reform, payment models, and costs, along with exponential scientific advancement and information overload—during last week’s conference, presenter after presenter touched on the compelling need to humanize medicine to help both providers and their patients. A number of speakers described how a new strategy, program initiative, workflow, or process change grew from an “Aha” moment triggered by an encounter with or experience of a single patient.  An interaction that stopped them in their tracks and connected them to new ways of thinking about care delivery.

One step toward humanizing medicine that echoed across sessions was the power of stories. For many of the presenters, either listening to or sharing a story, led to change. Attendees learned firsthand how sharing your story can empower cancer programs, providers, and patients.

For cancer programs, telling your story is at the heart of advocacy efforts, Tennessee Oncology CEO Jeffrey Patton, MD, told attendees, in welcoming them to Nashville. In today’s swiftly shifting healthcare environment, it’s critical for community oncology to have a voice. “No one is going to tell our story for us,” he said, reminding attendees that their experiences need to be included in the healthcare reform conversations occurring both locally and nationally.

Dr. Steven Eisenberg sharing the healing power of music.

For cancer care providers, sharing a story, an anecdote, or even a favorite song can be a simple step toward humanizing the provider-patient relationship. Featured speaker medical oncologist and “song-cologist” Steven Eisenberg, DO, California Cancer Associates for Research & Excellence, told how a pivotal interaction with Flavvy, an 80-year-old stage IV cancer patient who refused to let her medical problems diminish her vibrant love of life, changed his life and his approach to practicing medicine. “It freed me up to be a doctor who was in partnership with my patients. Rather than being separate from them, I started working with them,” he said.

By telling their story, cancer patients can help themselves, help others facing cancer, and help their care team understand who they are and what is important to them. Breast cancer survivor Brianne Joseph, LPI, owner of Sly Fox Investigations and author of Punk Azz Cancer, How Dare You! How to Turn Your Pain into Power, shared her story as a young adult breast cancer survivor, and included the voices of other young women survivors in her down-to-earth talk. “Everyone can see the scars from the mastectomy, but the scars that are the hardest to heal are the ones you can’t see,” she reminded attendees, urging better support for and communications with patients.

In Friday’s final conference session, the “art” and “science” of medicine were brought together in a powerful documentary, “Intentional Healing,” produced by Vanderbilt-Ingram Cancer Center radiation oncologist Mark Stavas, MD. The film follows famed Nashville music producer Jesse Boyce as he contemplates his own mortality after a diagnosis of terminal prostate cancer. Through the film we see how his art—creating music—was one of the ways Mr. Boyce pursued “intentional healing.” Afterward, an attendee asked how Dr. Stavas, whose practice is palliative radiation oncology, handles burnout and loss in his professional life. Making the film, sharing the patient’s story through art, has helped him to heal, Dr. Stavas said.

“Medicine cures, but art nourishes the soul.”

Exceptional.


Stay tuned to ACCCBuzz for more highlights from select ACCC 34th National Oncology Conference sessions.

ACCC Comments to CMS on Quality Payment Program Proposed Rule

By Blair Burnett, ACCC Policy Analyst

On August 21, 2017, ACCC submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the agency’s proposed 2018 updates to the Quality Payment Program (QPP), a two-track value-based reimbursement system created by the Medicare Access and CHIP Reauthorization Act (MACRA). The two tracks in which eligible clinicians can opt to participate are the enhanced fee-for-service based Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs), which require clinicians to take on more than nominal risk.

Under the QPP, 2017 performance will affect Medicare payments for all eligible clinicians in 2019. While many ACCC members have said they’re somewhat familiar with the program, others don’t feel quite as prepared to meet the specific program requirements.

In our comment letter, ACCC asked CMS for continued flexibility and additional clarity on how the MIPS adjustment will be applied in 2018. ACCC requested that:

  • CMS should continue to offer clinicians maximum flexibility in participating in the QPP, including through broad availability of alternative reporting options such as virtual groups, facility-based scoring, and MIPS APM reporting and scoring.

ACCC urges CMS to continue expanding the use of flexible reporting options that allow clinicians in diverse practices and communities across the country to participate in the QPP. Many ACCC practices are also currently participating in MIPS APMs, such as the Oncology Care Model (OCM), that do not currently qualify for the Advanced APM incentive outlined in the current proposal. ACCC advocates for more flexibility in what qualifies as an advanced APM and a continued flexible approach to allow clinicians to participate in the QPP to the best of their ability and in a manner that reflects the nature and priories of their practice and their patients.

  • CMS should finalize the increase in the low-volume threshold to $90,000 in Part B allowed charges and 200 Part B beneficiaries and clarify that the $90,000 threshold does not include the cost of drugs billed directly by clinicians.

ACCC supports increasing the threshold that exempts clinicians from the QPP based on a low revenue and patient volume because it allows practices with tighter resources to still successfully participate without fear of lower performance scores. We also ask CMS to clarify that the cost of the drugs billed directly by clinicians under Part B will not count towards the revenue threshold.

  • CMS should finalize its proposal to assign a weight of 0% to the cost performance category for CY 2018 and carefully implement the cost score in the future so that clinicians are assessed and scored against their peers and only for the costs of care for which they are responsible.

ACCC supports CMS’ proposal to delay scoring clinicians on cost for 2018 and urges CMS not to impose cost of care payment adjustments without accurate methodology. When considering how to assess cost under MIPS, we hope that CMS will: ensure fair beneficiary attribution for overall cost measures, establish narrowly tailored episode-based measures, apply its discretion  to reweight performance categories, and recognize the variable nature of costs through appropriate risk and specialty adjustments and exclusion of outliers.

  • Importantly, CMS should clarify that MIPS payment adjustments will not apply to Part B payments for drugs billed directly by clinicians.

ACCC strongly opposes applying the MIPS payment adjustment to Part B payments for drugs and urges CMS to clarify that the adjustment will not apply to drug payments. We are concerned that the application of MIPS adjustments to Part B drug payments would represent an unjustified change in agency policy, create incentives for clinicians to focus on cost of treatment rather than whether it is clinically appropriate, and create new barriers to access for patients.  

ACCC will update our membership when we see a final rule from CMS. Read our full comments.

ACA Repeal Efforts Stalled in Washington

by Blair Burnett, Policy Analyst, ACCC

U.S. Capitol

Despite much debate, healthcare reform remains in flux in Washington after a round of critical votes in the U.S. Senate this week. In the latest effort to repeal the Affordable Care Act (ACA), on Tuesday, July 25, the U.S. Senate voted 51-50, with Vice President Mike Pence breaking the tie vote, for a motion to proceed, which set up a process allowing for open debate and amendments to the AHCA, the House version of ACA repeal, on the Senate floor.

On Tuesday evening, the U.S. Senate brought to the floor their latest version of the Better Care Reconciliation Act (BCRA) with the added Cruz Amendment, allowing for sale of low-cost insurance plans if insurance policies that comply with the “essential services” provision of the ACA are also sold. The bill needed 60 votes to pass, but only received 43.

Debate continued Wednesday, July 26, and the U.S. Senate brought a repeal only bill to the floor, the Obamacare Repeal Reconciliation Act (ORRA), without language of a replacement effort. The vote, 45-55, showcased the lack of support among either party to vote for healthcare reform without actionable legislation.

As of Thursday, July 27, Senators were still in debate, bringing various amendments to floor for a vote. Late Thursday evening, a “skinny bill” was brought forth, that sought to roll back both the individual and employer mandate from the ACA. The text of this bill was not made available for public review, but besides repeal of the individual and employer mandate, left much of the ACA in place. When brought to a vote in the U.S. Senate, the bill failed, with a 49-51 vote in dissension of passage.

CBO estimates stated that the number of individuals insured would have decreased by 16 million by 2026 if the “skinny bill” were to pass and continue to become formal legislation. In the same time frame, the CBO estimates stated the federal deficit would have decreased by $142 billion, and premiums would have increased by an average of 20 percent.

For now, ACA repeal efforts and larger healthcare reform has stalled. More changes are certain to come from the Hill in the coming months as bipartisan healthcare reform legislation is expected to be drafted. Based upon the four pillars of ACCC’s health reform principles, a “skinny repeal” of the ACA would likely have destabilized current insurance markets, and placed increased burdens on cancer patients, specifically, elderly, low-income Americans accessing insurance in the individual and non-group markets. This week, ACCC joined over 30 other provider and patient groups to advocate against a skinny repeal of the ACA bill.

Senate Social Media Campaign - Skinny Repeal 7-27-17
As new legislation is brought forth, ACCC will continue to monitor and analyze impacts healthcare reform will have on cancer patients across the country.


ACCC members can gain an in-depth understanding of how CMS’ proposed CY 2018 Medicare rules will impact oncology by participating in ACCC’s August 9 webinar, “CMS Proposed 2018 OPPS & PFS Rules: What You Need to Know.” Learn more [member log-in required].

House Subcommittee Hearing Focuses on HRSA’s Oversight of 340B

by Blair Burnett, Policy Analyst, ACCC

U.S. CapitolThis week, the U.S. House of Representatives Subcommittee on Oversight and Investigations, of the Energy and Commerce Committee, chaired by Rep. Tim Murphy (R-PA), held a hearing titled, “Examining HRSA’s Oversight of the 340B Drug Pricing Program.” Health Resources and Services Administration (HRSA) is the agency within the U.S. Department of Health and Human Services that currently oversees the 340B Drug Pricing Program. The program’s inception in 1992 sought to provide discounted outpatient drugs to “covered entities” (DSH facilities, rural referral centers, freestanding cancer centers, non-profit hospitals, etc.) who provide a certain level of care to Medicaid and low-income Medicare patients, allowing covered entities to stretch scarce federal resources to provide affordable prescription drug coverage to all patients.

The hearing, convened on Tuesday, July 18, addressed how HRSA’s oversight can improve review of eligible healthcare facilities utilizing the program in the face of continued expansion of facilities that qualify. As of October 2016, there are 12,168 covered entities utilizing the 340B Drug Pricing Program, and this number has quadrupled since 2011. The hearing also sought to explore how HRSA can be more transparent with 340B Drug Pricing Program reporting, calling attention to gaps in current data collection efforts.

Witnesses who testified at the hearing included:

  • Krista M. Pedley, PharmD, MS, CDR, USPHS, Director, Office of Pharmacy Affairs, Health Resources and Services Administration, U.S. Department of Health and Human Services;
  • Debbie Draper, Director, Health Care, Government Accountability Office (GAO); and,
  • Erin Bliss, Assistant Inspector General, Office of Evaluation and Inspections, Office of Inspector General (OIG), U.S. Department of Health and Human Services.

Both the office of the GAO and HHS OIG have done significant work with the 340B Drug Pricing Program, and the witness testimony spoke to the recommendations both have made to HRSA. Both offices have also repeatedly reviewed HRSA’s regulatory capabilities with the 340B Drug Pricing Program and stated the need for more robust oversight. Based upon witness testimony and member questioning, key takeaways include:

  • Possible bipartisan legislation efforts that seek to grant HRSA more oversight of the 340B Drug Pricing Program.
  • Increased transparency from HRSA on 340B Drug Pricing Program costs and rules.
    Multiple members called for insight into how covered entities are utilizing any savings accrued from the 340B Drug Pricing Program. Within the current oversight from HRSA, there are no guidelines on how covered entities utilize or report 340B Drug Pricing Program savings.
  • Additional hearings to examine the 340B Drug Pricing Program within the subcommittee bringing in physicians and hospital executives to ask healthcare facilities how they are utilizing savings acquired from the 340B Drug Pricing Program.

Notably, this hearing convened shortly after the July 13 release of the Centers for Medicare & Medicaid Services (CMS) proposed 2018 Outpatient Prospective Payment System (OPPS) rule, which calls for a drastic reduction in Medicare Part B payments for outpatient drugs to all covered entities utilizing the 340B Drug Pricing Program from average sale price (ASP) plus 6 percent to ASP minus 22.5 percent in an effort to reign in the program. Rep. DeGette (D-CO), Rep. Schakowsky (D-IL), and Rep. Pallone (D-NJ) voiced concern over this proposal and called for bipartisan support to make meaningful reforms to the 340B Drug Pricing Program to ensure HRSA oversight is effective in aligning transparency as well as improved facility and overall data audits.

As policymakers continue to shine the light on the 340B program, over the next several weeks ACCC will continue to monitor efforts to reform the program and evaluate the impact the OPPS proposal will have on ACCC membership. Along with other stakeholders and coalition partners, we will be forcefully advocating for policies that are in the best interest of all community-based providers and their patients.


ACCC members can gain an in-depth understanding of how CMS’ proposed CY 2018 Medicare rules will impact oncology by participating in ACCC’s August 9 webinar, “CMS Proposed 2018 OPPS & PFS Rules: What You Need to Know.” Learn more [member log-in required].

Update from Capitol Hill

By Brittney Fairman, MPS, MA, ACCC Policy Analyst

U.S. CapitolAt the end of last week, it was anticipated that the U.S. Senate would hold a vote on the Senate Republicans’ revised version of the Better Care Reconciliation Act (BCRA) today, Tuesday, July 18. However, over the weekend,  Senator John McCain (R-AZ) underwent an emergency surgery and Senate Majority Leader Mitch McConnell (R-KY) announced that the vote on BCRA would be postponed until Senator McCain’s return to Washington, D.C. With two Senators, Rand Paul (R-KY) and Susan Collins (R-ME), already openly opposed to voting ‘Yes’ on BCRA—Senator McCain’s absence would have put the Republican Senators’ vote on the bill at risk.

In order to continue the repeal and replace of the Affordable Care Act (ACA), Senate Republicans would need at least 50 of the 52 Senate Republicans to vote in favor of BCRA.

On Monday evening, the bill took another turn when Senator Mike Lee (R-UT) and Senator Jerry Moran (R-KS) jointly announced their opposition of a motion to proceed on the revised healthcare bill. These two additional defections on Senator McConnell’s bill means the Senate Majority does not currently have the votes to even begin debate on the legislation to repeal and replace the Affordable Care Act (ACA).

So at this point, the future of BCRA remains uncertain. On Monday evening, Majority Leader McConnell stated, “Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful.” President Trump has suggested the Senate Majority move forward in repealing the ACA without immediate replacement.  In this scenario, the Senate would vote in the coming days on a bill which would delay the ACA’s repeal for two years as Republicans work on individual bills to dismantle the current healthcare law.

ACCC will continue to monitor the Senate’s actions and keep ACCC members posted with the latest updates.

A Strong Voice in Challenging Times

By Amanda Patton, ACCC Communications

ACCC Capitol Hill Day 2017On Capitol Hill yesterday, in nearly 100 meetings with legislators and staff, ACCC advocates spoke out sharing the real-world impact of policy on cancer patients and cancer care delivery in communities across the country. Walking the halls of Congress were ACCC member physicians, nurses, administrators, pharmacists, social workers, financial advocates, and other members of the care team—from cancer programs and practices large and small—representing 23 states.ACCC Capitol Hill Day 2017

In conversations with legislators ACCC advocates urged that Congress:

  • Protect patient access to care, encompassing access to comprehensive affordable insurance coverage
  • Maintain meaningful access to clinical trials
  • Reject the NIH funding cuts proposed in the President’s FY 2018 budget and instead increase funding for NIH and the National Cancer Institute that is critical to our federal research infrastructure
  • Support federal oral parity legislation

Rep. Higgins-ACCC 2017 Hill DayDuring a lunch address, Congressman Brian Higgins (D-NY), who co-sponsors the Cancer Drug Parity Act of 2017 (H.R. 1409) told ACCC members, “Your constituents are our constituents,” and “your presence here [on Capitol Hill] is very important.”

In these challenging times, as Congress continues to deliberate reforms to our healthcare system, ACCC advocates spoke with a united, strong voice, encouraging their legislators to set aside politics and put patients first. Summing up the experience, Hill Day participant ACCC President Jennie R. Crews, MD, MMM, FACP, said, “Being on Capitol Hill today, it’s apparent that health reform is not dead and we need to remain vigilant that protections are there for our patients.”


ACCC Capitol Hill Day kicks off the ACCC 43rd Annual Meeting, CANCERSCAPE. Follow the meeting conversation on Twitter using #CANCERSCAPE as we live-tweet top takeaways. Stay tuned for blog updates with meeting highlights.

Why I’m Going to Capitol Hill On March 29

By Virginia Vaitones, MSW, OSW-C

U.S. CapitolACCC Capitol Hill Day 2017 happens to coincide with national Social Work Month, which the National Association of Social Workers is marking with theme Social Workers Stand Up.  As an oncology social worker, this year I’m putting on my patient advocate’s hat, standing up, and going to Capitol Hill to share with legislators the stories of how my patients are being impacting by worry and uncertainty about how  changes to the Affordable Care Act and the Medicaid program may affect their insurance coverage and access  to care.

My home state of Maine has the distinction of having the oldest population in the country per capita and Knox County, where I live and work, has the oldest population in the state.  Many of my patients who are on Medicare also have MaineCare (Maine’s Medicaid program) as their secondary insurance.  The current proposed changes to how the federal government supports states with Medicaid funding will have a tremendous impact on my patients.

Besides the elderly population that I need to advocate for, the proposed cuts and changes in payment will have an impact on my younger patients who become disabled with their cancer diagnosis and depend on Medicaid to cover the cost of their cancer treatments.  As a patient advocate, I will be standing up for these patients as well.

My advocacy skills also are needed to bring the stories of how cancer impacts parents, small business owners, and working adults with a cancer diagnosis, who for the first time were able to afford health insurance under the ACA and now face uncertainty about whether they will have coverage or be able to continue to afford the cost of coverage.

Last but not least, I work in a rural community hospital whose doors are always open and that will treat patients whether or not they have insurance coverage.  I need to advocate for my hospital so that we can keep our doors open.

Capitol Hill Day, March 29, will bring together ACCC members representing cancer programs from across the country.  Together we will be standing up for our patients, for access to quality care close to home, and for our cancer programs.


Virginia Vaitones, MSW, OSW-C, is oncology social worker at Pen Bay Medical Center in Rockport, Maine, and a past president of the Association of Community Cancer Centers (ACCC). 

Speak Up Now!

by Leah Ralph, Director of Health Policy, ACCC

U.S. CapitolFor this year’s ACCC Capitol Hill Day, Wednesday, March 29, ACCC advocates will descend on Washington, D.C., with newfound motivation. As Congress grapples with the future of the Affordable Care Act (ACA) and debates the merits of protecting patients with pre-existing conditions vs. high-risk pools, refundable tax credits vs. subsidies, requirements for essential health benefits vs. more flexibility in benefit standards, oncology care providers see insurance coverage—and their patients’ access to cancer care—at stake.

Yes, It’s Complicated
The political messaging—not to mention policy minutiae—is difficult to sort through, even for the wonkiest of policy wonks in Washington. The ACA has been plagued with insurer drop outs and significant premium increases for the unsubsidized individual market, but the law has also provided critical patient protections, put an end to discriminatory practices by insurers, and covered 20 million new lives through Medicaid expansion and the health insurance exchanges. Having made ACA repeal their rallying cry for years, Republicans are now trying to find a path forward to make changes to the law. But maintaining those critical (and politically popular) patient protections, preserving essential benefits, and covering more people while also reducing costs for both the system and the patients is far from an easy task.

Preserve Patient Protections
More than ever before, this year on Capitol Hill Day, ACCC members have a critical story to tell about the unique needs of cancer patients and the costs of their treatment. Cancer, in many ways, demonstrates the precise need—and role—for insurance. Cancer diagnoses are inherently unpredictable. Cancer patients can’t plan when they are going to be sick or what kind of insurance they will need to cover their costs. In addition to the personal, emotional, and physical toll a cancer diagnosis takes on individuals and their families, cancer patients need good insurance to protect against the risk of catastrophic treatment costs.

The ACA created critical protections for consumers, including eliminating the ability of insurance companies to discriminate based on a pre-existing condition, like cancer, or to impose lifetime or annual dollar limits on policies. And by providing subsidies to those up to 400 percent of the federal poverty level to purchase insurance, the ACA made progress in closing the disparities gap in accessing cancer care.

Protect Patient Access to Care
In record numbers, ACCC members will set out on March 29 to educate Congress on what proposed changes to the ACA would mean for cancer patients and survivors and their ability to access high quality cancer care in the communities where they live and work. In the context of any ACA repeal and/or replace plan, ACCC members will ask legislators to:

  • Protect access to comprehensive, affordable insurance coverage. This is particularly critical for cancer patients facing high-cost treatments that often turn into chronic, long-term conditions.
  • Preserve critical patient protections, such as the ban on discriminating based on pre-existing conditions, no annual or lifetime limits, guaranteed issue, and allowing dependents to remain on their parents’ plan until age 26.
  • Preserve essential health benefits that require insurers to cover preventive services, like cancer screenings, at minimal or no cost-sharing.
  • Maintain meaningful access to clinical trials.
  • Strengthen patient access to adequate provider networks that include cancer specialists and the full range of services required to provide quality cancer care.
  • Meaningfully engage cancer patient and provider groups in any real effort to repeal and/or replace the ACA.

Beyond coverage and access, ACCC members will also reiterate their commitment to value-based care and any efforts to improve quality, affordability, and access in cancer care. ACCC has long been committed to working with the Centers for Medicare & Medicaid Services (CMS) to achieve true high-value, cost-effective cancer care. ACCC members support the mission and goals of the ACA-created Center for Medicare and Medicaid Innovation (CMMI), which has been the subject of recent scrutiny. More than half of the CMMI Oncology Care Model (OCM) participating practices are ACCC members. These forward-thinking practices are dedicating significant time and resources to making this pilot program work.

However, in the wake of last year’s CMMI ill-conceived proposed Part B Drug Payment Model, ACCC members will also strongly encourage Congress to place additional guardrails on CMMI’s authority, including limiting its scope to targeted, voluntary (rather than mandatory) demonstration programs.

ACCC members have a lot to communicate to busy Congressional representatives and staffers this year. But the stories we will share, from the communities in which ACCC members are working on the frontlines of cancer care, will bring home the impact of policy decisions in the clearest, most powerful terms. Now is a critical time to speak up and be heard—for our patients today and those who will become our patients tomorrow. Join us for ACCC Capitol Hill Day. Your story can make a difference.


The ACCC 43rd Annual Meeting, CANCERSCAPE, March 29-31, will provide a 360-degree look at the healthcare landscape from the Democrat and Republican perspectives with insights on what to expect for reimbursement, alternative payment models, drug pricing, quality reporting, and more. Learn more.

On the Road to Value-Based Care: Operational & Cultural Change

By Monique J. Marino, Senior Manager, Publications & Content, ACCC

2017-Open-Road-smWhile there can be no single roadmap for transitioning to value-based care, a panel session at the 2017 Cancer Business Summit, February 6-7, 2017, co-hosted by the Association of Community Cancer Centers, focused on  Operational & Cultural Change  that can help cancer programs move forward on the path ahead.  Sarah Chavarria, Chief People Officer, NantHealth, shared that successful organizational alignment is centered around these key concepts:

  • Strategy: mission, vision, and values; organizational goals; brand.
  • Structure: placing the right talent in the right role; holding people accountable for meeting organizational goals.
  • Talent: managing against a set of value-based competencies; assessing, developing, and growing the “best and brightest.”
  • Rewards: creating incentives that drive collaboration to deliver on organizational goals; these incentives should be flexible in design to attract and retain top talent—in other words, identifying what your employees value so that the organization can package them and reward behavior they want.
  • Systems and processes: these should enable decision making and responsiveness, and support effective execution.

“Cancer programs should create a ‘Deliberate Culture,’” Chavarria concluded. “If you are not deliberate in defining your culture, it will just happen; and it will not be what you want.”

Panelist James Grayson, a High Reliability Organization Specialist at West Cancer Center, outlined five key steps to help cancer programs succeed operationally and culturally:

Step. 1 Set your bar higher than everyone else’s.

Step 2. Hire people with potential.

Step 3. Invest in your front-line management team.

Step 4. Invest heavily in safety, risk management, leadership, and talent development.

Step 5. Be the cancer program your patients and staff need you to be.

Rounding out the panel was 2017 Cancer Business Summit Innovator Award Winner, Barry Russo, MBA, Chief Executive Officer, The Center for Cancer and Blood Disorders, who told attendees about the steps his cancer program took to move to value-based care, including:

  • Centralizing patient intake from 9 practice locations to 1 location, streamlining and improving care coordination.
  • Establishing triage as its own business unit.
  • Implementing an internal case management program to facilitate proactive intervention and risk stratification of patients.
  • Growing supportive care services (an effort that requires continual identification of new funding avenues), such as palliative care, chaplaincy services, nurse navigation, survivorship, etc.
  • Implementing a new patient education program.
  • Identifying technology gaps and improving decision-support around data and analytics.
  • Developing communication tools around value-based care to share with employer and payer communities.

To help cancer programs prepare for the change to value-based care, Russo offered five high-level takeaways:

  1. Deliver a consistent message; identify the changes needed and understand how to make these changes.
  2. Establish a new norm—while still a physician-centric care delivery model, ALL members of the care team are essential to healing lives after cancer. Value-based care requires cultural change and significant organizational re-engineering.
  3. Understand that staff and clinician education is a journey and not a destination. Accept that leadership must focus on education, re-education, and then more education. Effective team building requires repetition—leadership rounds, nursing forums, regular reports from pillars in the cancer program, etc.
  4. Be aware that nursing needs a hyper-focus. Nurses enjoy the most touch points with patients, so nursing stability is of the utmost importance to successful cancer programs.
  5. Build strong teams at EVERY level of the organization; teams that can process constant change. The move to value-based care is not for the faint of heart. Staff must be able to accept feedback; brutal honesty is essential to the process. Staff must accept that the move to value-based care means change is interrupting their day, not making it easier.

Learn more about what lies ahead for value-based care at the ACCC 43rd Annual Meeting CANCERSCAPE, March 29-31, 2017, in Washington, D.C. Join your peers to hear from leading experts and decision-makers about the evolving healthcare policy landscape, the latest on alternative payment models, data collection and quality measures, and more. Explore the meeting agenda here.

 

CMS Part B Drug Demo Unlikely to Move Ahead

By Leah Ralph, Director of Health Policy, ACCC

Centers_for_Medicare_and_Medicaid_Services_logoJust before Thanksgiving, top Senate Democrats asked the White House not to issue a final rule on the Center for Medicare and Medicaid Innovation (CMMI) proposed Part B Drug Payment Model – a national program that would significantly reduce reimbursement for Part B drugs. This was  a good sign for our efforts against the proposal, and on November 21, we passed an important deadline for CMMI to release a final rule. We are now within a 60-day window of the new Administration taking office, which, if a final rule were to be released, due to a series of administrative rules in Congress, makes it much easier for the new Administration to simply pull back the rule rather than having to do it legislatively.

Simply put: we passed a critical deadline, and we’re very optimistic that we will not see a final rule on the Medicare Part B Drug demonstration for the remainder of the current Administration. ACCC spoke out strongly against this ill-conceived proposal. Hundreds of ACCC members weighed in with their members of Congress, and ACCC produced financial analysis that we shared with the committees of jurisdiction in both the Senate and House of Representatives that showed precisely how devastating cuts to Part B drug reimbursement under this proposed model would be on both practices and hospitals. ACCC thanks you for your efforts to block this poorly-conceived experiment. This is a victory for cancer patients and providers across the country who can now continue to provide high-quality cancer care close to home.

With a new year and a new Administration upon us, we will continue to face both opportunities and challenges in the oncology policy landscape. ACCC is committed to preserving the cancer delivery infrastructure, and we will continue to work with policymakers to develop thoughtful policies around value-based care and an appropriate, sustainable reimbursement system for all settings of care.